What are Trigger Points
Trigger points, as defined by Janette Travell, are hyperirritable spots in skeletal muscle that is associated with a hypersensitive palpable nodule in a tight band. They are extremely common and will affect the majority of the population at least once in their lifetime. In community medical centres, trigger points have been found to contribute to pain complaints in as many at 93% of cases and in 74% of these cases, these were identified as the primary cause of pain.
Trigger Points vs. Acupuncture Points
Trigger points are often confused with acupuncture points. While they are different in their definition and presentation, there is a high degree of correspondence between the two. Trigger points are palpable, hyperirritable spots found in skeletal muscles and often described as a ‘knot’ by clients. Acupuncture points, however, are prescribed points along energy meridians that are defined by ancient Chinese documents. Trigger point knowledge is used as a foundation for Myofascial Dry Needling whereas Acupuncture is based around the acupressure points.
Types of Trigger Points
Travell’s research established the common locations, characteristic referral patterns and early pathophysiology theories of trigger points, which help Remedial Massage Therapist and Myotherapists to locate the most effective sites for treatment. Not all trigger points are the same though and the cause, clinical presentation and treatment approach can vary depending on the type of trigger point. Knowledge and the ability to identify this can help to provide more long-term relief of symptoms.
The different types of Trigger points include:
- Active – A myofascial trigger point that causes a clinical pain complaint (always tender, restricts ROM, causes weakness, refers pain, local twitch response when stimulated, causes tenderness in the referral zone). These are the most common.
- Latent – Will only be painful when palpated but otherwise may have all of the clinical characteristics of an active trigger point.
- Primary – A central trigger point that was activated directly by acute or chronic overload, or repetitive overuse of the muscle in which it occurs.
- Associated – A trigger point in one muscle that occurs concurrently with a trigger point in another muscle.
- Attachment – Located at the attachment of a muscle produced by the tension created by a central trigger point.
- Central – Located near the centre of muscle fibres
- Key – Responsible for activating one or more satellite trigger points which when deactivated, will inactivate its satellite trigger points.
- Satellite – a central trigger point that was induced by the activity of a key trigger point.
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