Trigger points are a complicated and misunderstood cause of pain. They are more than just “knots”, and they may be responsible for symptoms quite distant from the points themselves (referred pain).
Trigger points (TrPs) have been described in a number of ways, but “micro-cramps” might be one of the better ones. Cramps cause part of a muscle to contract, forming a tight ball of muscle. One theory is that these persist because the contraction reduces the muscle’s own blood supply, making it harder to relax again. They may also be maintained by the factors that originally caused them, such as increased demand on the area. Sometimes they seem to develop around another injury.
They become a problem when they do not self-resolve, or they become very tender. You might find that self-massage, stretching, or heat or ice can help, but sometimes they seem to be immune to everything you try. Generally, we expect simple soft-tissue problems to resolve within 6 weeks.
We know that pain that persists for longer than 3-6 months can be considered chronic. At this point, the brain may begin to process the pain differently, making it more complicated and harder to resolve. If your pains sound like TrPs, make sure you’re doing something to help yourself sooner rather than later. You can click the booking link at the bottom of the page if you’d like to see one of our osteopaths in Devizes or Pewsey.
Referred Pain
We’ve spoken about referred pain before. To summarise, this is when the brain and body misinterpret the source of a pain signal. It’s a common phenomenon, and not a sign that anything is wrong in the way your pain is processed. The patterns of referred pain are not random, and with experience they can be quite easy to spot. For example, the SIJ can refer pain down the back of the legs in a way that looks a bit like sciatica. Questioning and examination will show us that it’s not actually a trapped nerve, so we can treat the right area.
The same process is common with trigger points. The image above shows the patterns of some trigger points in the face and neck. These points can be particularly significant, as a trigger point within the illustrated muscle of the cheek can present as a toothache. A trip to the dentist might be reassuring when results show that the teeth are fine, but you might still be left without answers.
Managing Trigger Points
Unfortunately, as with many conditions where the research is lacking, there is no specific cure for TrPs. An approach aiming to relax the contracted area may suit you, whether using hands on techniques, stretches, or dry needling.
A holistic, osteopathic approach would be to try and work out why the trigger point developed in the first place. If it’s the muscle in the cheek, could that be related to teeth-grinding or a jaw problem? Alongside direct treatment to the TrP itself, we might want to look further afield to take the demand off the muscle in the first place. As always, this may be complemented with advice and exercises to continue at home.
Click here to make an appointment for your trigger points in Wiltshire
