A trigger point is a knot in the center of a muscle belly.  It feels like a lump under fingertips the size of 2-10 mm.  Some trigger points are painless, while others are hyperirritable and may produce pain syndrome locally or referred to another body part.

Myofascial pain syndrome refers to pain that arises from trigger points within the muscle or fascia.

Trigger points may arise anywhere in the body, but commonly seen in the neck, midback and lower back muscles and ITB.

WHAT ARE THE CAUSES OF TRIGGER POINTS?

  1. Lack of exercise
  2. Poor muscle mobility and flexibility
  3. Bad posture
  4. Muscle overuse
  5. Chronic physical or psychological stressors
  6. Sleep disturbance
  7. Underlying conditions, such as arthritis, diabetes, fibromyalgia, migraine headaches
  8. Injury to muscles or joints

SYMPTOMS

Active trigger points in the neck and upper back may cause

  1. Migraine or tension headaches
  2. TMJ (jaw pain) syndrome
  3. Neck stiffness in the morning
  4. Difficulty moving head side to side
  5. Blurred vision
  6. Slouched posture
  7. Difficulty to use computer or drive for long time

Active trigger points in the lower back may cause:

  1. Sciatica
  2. Painful movement when bending, twisting, walking, driving, running or squatting
  3. Muscle weakness
  4. Stiffness in lower back
  5. Difficulty getting out of bed in the morning
  6. Difficulty lifting heavy weights

DIAGNOSIS

On the first visit a physical therapist will ask a patient about:

  1. Location, nature and intensity of pain
  2. medical history including fibromyalgia, diabetes and injuries.
  3. Level and intensity of physical activity including job related and daily routine.
  4. exercise routine
  5. medications

Examination includes muscle palpation and observation, muscle strength and flexibility tests, range of motion tests and postural examination.

Jump sign is a response of a patient to pressure on a trigger point.  Individuals are frequently startled by the intense pain.   They may wince or cry out, move involuntarily or jerk a body part not being palpated.  A jump sign is an indication of extreme tenderness and irritability of the trigger point.

TREATMENT

Treating trigger points with physical therapy is a great way to alleviate pain and avoid injections.  The treatment includes postural awareness and muscle re-training, muscle strengthening and stretching, soft tissue massage and hot stone massage.   Foam roller is used on tight quadriceps and ITB.  Taping technique helps to support painful muscles, while ultrasound, electrical stimulation and laser therapy decrease pain and tenderness of the trigger point.

Early treatment is the key to recovery and a healthy lifestyle.  At Excel Physical Therapy, we understand your pain.  We have the necessary expertise and equipment to help you heal. For any questions or further information, please contact our expert physical therapists at 718-301-6363 to schedule a consultation today.

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