What are trigger points?

“A highly irritable localised spot of exquisite tenderness in a nodule in a palpable taut band of muscle tissue.” Dr Janet Travell and David G. Simons

Let me explain what that means and why you should care.

First, a quick bit of physiology. You may imagine your muscles as a solid lump. But in fact they are made up individual fibres. Fibres that glide freely as you either move (shorten) or relax (lengthen) your muscles.

Sometimes these fibres get stuck together. Your brain takes notice and goes, “Oh, so those muscles fibres are supposed to be stuck together? OK. Done”. Now you’ve got a trigger point.

And so the fun begins. Those stuck muscles fibres cause the nerves to send signals to your brain. More of that in a mo.

Who gets trigger points?

Just about everyone. Including babies and children.

OK. And when I get them, what happens?

When your brain receives those signals it has to decide what they mean. Are you in danger? If the brain decides yes, it sends out a pain signal. (Remember, pain is your inbuilt early warning system.)

Now, maybe you’ve heard your brain talked about as a supercomputer. Sounds pretty swish, right? And your brain is astoundingly amazing. But. It doesn’t always get it right. All of the time. Sometimes, it makes a best guess. This is where things get interesting and a little tricksy.

With trigger points, the pain signal gets sent to a different place from where the danger signal began. That’s the referred pain bit.

One of the most common migraine trigger points I come across in my clients are in a muscle with the fabulous name of sternoidcleidomastoid. Or, to its friends, the SCM.

Your SCM starts at the base of your skull, comes down the side of your neck and attaches to your breastbone and collarbone. Here are just a few examples of SCM referred pain:

*deep eye pain
*pain behind the ear
*headache over the eye
*headache in the crown of the head
*cheek pain that feels like sinusitis

And all from a muscle in your neck.

“But wait! I don’t have my symptoms all of the time”

nothing happens until you apply extra pressure to the afflicted muscle. Then. BAM! Trigger point becomes active. Symptoms flare-up.

“My condition is chronic, I’ve been told that nothing can be done”

Frustrating to be told that, isn’t it? Kind of shuts down any hope. And so you cut back on, and then stop entirely, doing what you love to do. The things that make you you.

Yet trigger point pain is thought to be the main cause of as much as 85 percent of the pain seen in pain clinics.

How are they treated?

Trigger Point Injection
One option is to insert a needle into the trigger point within the muscle. This though can be difficult to do accurately. Remember a trigger point can be no bigger than a pea. Sometimes, no larger than the size of a pin head. And accuracy is key when treating trigger points.

Each trigger point within a muscle also needs to be treated. Needle injection limits the number of trigger points that can be treated in any one session.

All this aside, it may be the quickest way to treat recent trigger points, that you haven’t had for too long.

Manual Therapy
A skilled therapist can feel, locate and release individual trigger point through touch. It requires a highly developed sense of touch. They can distinguish between regular muscle tissue, everyday knots and trigger points. Because each one has a different texture and therefore feel.

An experienced therapist will have good communication skills, too. Because only you know what you it feels when one of your trigger point is prodded. You need to let your therapist know. You need to have a conversation.

(On a side note, during my training I was taught to use the terminology of palpation. Not one of my clients never ever says, “When you were just palpating my SCM”. No. Without fail, they say something along the lines of “when you just prodded that bit there, I felt…”. And that’s OK with me).

Multiple trigger points can be treated during any one session. The immediate effect may well be less than with an injection. But for long term conditions, where it is highly likely that you’ll have multiple trigger points, it is the safest and most effective approach.

Is that all I need to know?

No. (You were waiting on that answer, I bet).

Trigger points are created as a result of how you’re living your daily life. You need to unravel that puzzle. But right now, you don’t know what you don’t know.

An experienced therapist will work with you to tease out the answers. And teach you how to make the simple, do-able everyday changes that’ll help you to get your life back.

Because that’s what it’s truly all about. Not just the pain. No just the symptoms.

It’s about you having the freedom to do what you love doing. Worry free. Whether that’s heading up into the hills or enjoying your daily run.

In short, doing what makes you YOU