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What is Myofascial Trigger Point?

September 2, 2014

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How many of us have had neck and shoulder pain after hours of sitting at a computer? We start to massage our shoulders and we feel that “knot.” Then we continue to compress the knot and we start to get a radiating pain into the back, neck and head. The referral pain pattern looking something like this:

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Well, what is that “knot”? How did it form? Why does it hurt so badly? In physical therapy we refer to that “knot” as a myofascial trigger point. Myofascial trigger points are hyperirritable spots, usually within a taut band of skeletal muscle or in the muscle’s fascia. The spot is painful when compressed and can give rise to characteristic referred pain, tenderness and autonomic phenomena.

There are several potential causes for myofascial trigger points which include acute or chronic muscle overload, disease, psychological distress, homeostatic imbalances, trauma, and radiculopathy. It is believed that a trigger point may form due to an increased release of biochemicals, which cause a sustained contraction and hypersensitivity of the muscle. This sustained contraction limits circulation and causes an energy deficit within the muscle. This change in the muscle fiber can lead to localized pain, referred pain, muscle weakness and altered biomechanics at a joint.

Referred pain is pain perceived in an area that is away from the site of the painful stimulus. As shown in Figure 1, the trigger point is located in the Upper Trapezium muscle but the pain can be referred up into the neck and head.

Muscle pain has a unique neurobiology with distinctive characteristics that are critical in explaining the clinical presentation of myofascial pain. Muscle pain can often be described as aching, cramping, deep, and difficult to localize. Muscle pain also involves pain specific neurons in the brainstem and spinal cord and activates unique cortical areas associated with affective or emotional components of pain.

There are several interventions available to treat myofascial trigger points. Some of these include massage, medications, and injections with anesthetics. One very effective intervention that we use at Bodies in Motion Physical Therapy is trigger point dry needling.

Trigger point dry needling is the use of a small needle to deactivate trigger points to ‘loosen’ shortened muscles, restore motion and function, and to induce a healing response in the tissue. It is believed that when a needle is inserted into a muscle there are mechanical, neurophysiological, and chemical effects that occur in that muscle. Research studies have shown that these effects may include the following: a disruption of the dysfunctional motor end plate, a localized twitch response resulting in the alteration of muscle fiber length, activation of the inhibitory system of the central nervous system to suppress pain and a balancing of bio-chemical irritants within the myofascial trigger point.

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Your physical therapist will be able to properly evaluate and assess your musculoskeletal system to determine your impairments and functional limitations to develop an appropriate plan of care for you so that you can return to a pain free and functional lifestyle.
If you have any questions, please feel free to contact your local Bodies in Motion physical therapist at any of our three convenient locations. http://www.bodiesinmotionpt.com/

References

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