Healing Hands: Myofascial Trigger Point TherapyA trigger point is an area of muscle fibers that are in continuous contraction located within a tight band of muscle. This hypoxic “knot” (Partland and Simmons 2013) can be felt as a lump that twitches when pressed and can also be very tender, sting, and have increased referred pain.
Referred pain can be pain that has the same intensity as a trigger point in the same muscle but away from the trigger point itself. You can possibly feel these knots in your own neck and you already know how painful they can be.
People I work with who have headaches, TMJ(Temporomandibular joint dysfunction)problems, sciatica and several other conditions experience relief from trigger point therapy. Therapeutic massage approaches trigger points manually by slowly working the muscle and the fascia, locating the trigger points in specific muscles, and applying steady deep pressure and digital compression which allows the hypoxic area to contract less, relax and release. The entire length of the muscle is massaged following the release of the trigger point.
My observations are that chronic trigger points can take more than one session (sometimes many sessions) to resolve, however trigger points that have occurred in the very recent past can be resolved in one session. A stiff neck following poor sleeping posture is relieved with relative ease compared to Temporomandibular joint dysfunction (TMJ).
The medial pterygoid trigger point release often reduces pain and increases the low range of motion range associated with TMJ. Headache relief is another condition I see being effectively treated by manual trigger point therapy. By releasing neck muscle trigger points the pain from headaches dissipates. With routine application of trigger point therapy most of the people I see don’t experience headaches.
Piriformis trigger points mimic sciatica, pain in the lower back that can extend to the bottom of the foot. There are several different causes for sciatica, but the condition that therapeutic massage can help with is caused by trigger points in the piriformis muscle (Travell and Simmons 1999).
The sciatic nerve is compressed as it passes through the pelvis by the piriformis causing the discomfort. Releasing the tension on the muscle releases the pressure on the nerve. These conditions and several other myofascial pain syndromes are effectively treated using trigger point therapy.
Trigger point therapy was introduced by Travell and Simmons in a landmark two volume myofascial manual in the early 1980s as a way to treat myofascial pain syndromes of all types.
Therapeutic massage uses compression to release trigger points while skilled physicians use needles with or without medication. Controversy abounds over exactly what trigger points are and why they develop, such as whether headaches are caused by trigger points or whether trigger points cause headaches.
My observation is that trigger point therapy has a valuable place in the therapeutic massage tool box, as it reduces the amount of pain and stress allowing for better sleep.
If you are suffering from these types of muscular pain then talk to your doctor to make sure you are a good candidate for massage therapy. Next, call your local licensed massage therapist and ask about trigger point therapy and how it can help you reduce or eliminate your pain!
References:
John M. McPartland David G. Simons. “Myofascial Trigger Points: Translating Molecular Theory into Manual Therapy.” Journal of Manual & Manipulative Therapy, 2013
Travell, Janet, and David Simons. “Apropos of All Muscles.” Travell and Simons’ Myofascial Pain and Disfunction: The Trigger Point Manual, Second ed. New York: Lippincott Williams &Wilkins, 1999. 141-147.
Gregory Barthell graduated from The New Mexico Academy of Healing Arts with diplomas in both therapeutic massage and polarity therapy. After passing the National Board examination for bodywork, Barthell received his Massage Therapy License from the state of New Mexico. His practice, Sunrise Therapeutics, is in downtown Los Alamos. Call 505.661.4835 or email gbarthell2@gmail.com for more information.
