Sunday, July 26, 2020

Do You Need To Treat Your Trigger Points?

A common comment I get from patients is that they have "trigger points" in their muscles. Either they have been told by someone else treating them or they have read somewhere that "trigger points" are sore, painful areas in their muscles.

Trigger points are often assumed to be specific areas of tenderness in a muscle which can cause generalized musculoskeletal pain when over stimulated. It is believed that most of this occurs because of muscle overuse, muscle trauma (or injury) or even psychological stress.

Trigger points are also thought to arise from sustained repetitive activities like working on a computer/ phone all day or lifting heavy objects at home or work.

Trigger points feel like a lump or knots just under the skin. When pressing on trigger points, most people don't feel any pain or discomfort although there are others may feel pain.

If you google "trigger point therapy" the following shows up (see picture above). Many physiotherapy clinics and other healthcare professionals advertise and make money by claiming to be able to treat your trigger points.

I have also had some of my patients that me that some health practitioners they see say that trigger points are distinct areas of localized inflammation. However published evidence suggest otherwise.

Patients with chronic tension-typed headaches were matched with a healthy control group that had no such trigger points in the trapezius muscle.

Samples after needles were inserted into the patients at rest, 15 and 30 minutes after static exercise (10% of maximal force). All samples were coded and analyzed blindly.

The researchers found no difference in resting concentration of inflammatory mediators or metabolites between patients with tender trigger points and non tender controls. There was also no change after exercise.

The researchers suggest that the trigger points are not sites on ongoing inflammation.

Now you know. Trigger points are not sites of inflammation. You do not have to treat it. Getting rid of trigger points may not solve the problem.


Ashina M, Stallknecht B et al (2003). Tender Points Are Not Sites Of Ongoing Inflammation- In Vivo Evidence In Patients With Chronic Tension-type Headache. Cephalalgia. 23(2): 109-116. DOI: 10.1046/j.1468-2982.2003.00520.x

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