Contributed by: Perry Nickelston, DC, NKT, FMS, SFMA
What is a trigger point? In simple terms it is a muscle knot that can wreak havoc on your body by referring pain, weakening muscles, and causing dysfunctional movement patterns. Trigger points are hyper-irritable spots located in a taut band of skeletal muscle and often accompany chronic musculoskeletal disorders. Acute trauma such as slips and falls or repetitive micro-trauma from poor posture may lead to the formation of trigger points.
Why does movement matter? When you don’t move well, your body begins to compensate trying to correct itself so you don’t get hurt. Unfortunately, it does so at your body’s expense in the long run. Muscles weaken, while others tighten and get stiff, joints lock up becoming less mobile and you lose stability (body control). This is the start of the so called chain of pain!
Trigger points are very elusive. They are rarely if ever located at the site of pain! The SITE of pain is not the same as the SOURCE of pain. He who chases the site of pain is forever lost! Learning common pain patterns from trigger points will become a vital part of your understanding of how to conquering them.
There are different types of trigger points, however they all cause problems. You might not ever discover what sets off a trigger point. It can be anything. And it’s usually the simplest of actions that can fire them up; ‘I don’t know what happened, I just turned and then I had pain!’ ‘I was bending over to tie my shoe and my back went out.’ ‘All of a sudden my shoulder started to hurt when I was lifting.’ Common stories that happen every day to real people.
So what are the types of points?
ACTIVE…they are actively and currently causing pain.
LATENT…these are the dormant sleepers causing dysfunction to muscle, joint and movement, but have not yet fired up their pain zones. You don’t know they are there until you find the spot and apply pressure….PAIN.
SATELLITE…these points form in reaction to other points. These develop in the pain referral zone of the active or latent points. It’s the classic domino effect.
Trigger points are often treated with acupressure, dry needling, trigger point injections via medication and modalities like ultrasound or muscle stimulation. Deep tissue laser therapy is another effective modality in reducing the pain associated with myofascial trigger points. Laser therapy stimulates a cascade of pain relieving chemical regeneration properties in the area affected by the trigger point. Just a few minutes of laser therapy applied to a trigger point may cause immediate reduction in pain. Laser therapy excites the kinetic energy within cells by transmitting healing energy known as photons. The skin absorbs these photons via a photo-chemical effect, not photo-thermal; therefore it does not cause heat damage to the tissues. As such, laser can be safely used on patients who have metal joint replacements without the risk of injury. Laser light does not excite or interact with the molecules in metal or plastic.
Once photons reach the cells of the body, they promote a cascade of cellular activities. They can ignite the production of enzymes, stimulate mitochondria, increase vasodilatation and lymphatic drainage, synthesize ATP and elevate collagen formation substances to prevent scar formation. This is a critical step in reducing long-term disabling chronic myofascial pain syndromes and joint restrictions.
Example of deep tissue laser therapy on a trigger point for elbow pain. Tennis elbow (lateral elbow pain) can be very painful and is often difficult to treat. However, a primary trigger point that often refers pain to the elbow mimicking this condition is the supraspinatus rotator cuff muscle of the shoulder. It is often overlooked as a symptom contributor to the elbow pain. Applying 3-4 sessions of laser therapy over the supraspinatus as well as the elbow may lead to a reduction elbow pain.
Picture Courtesy of Travell and Simons Myofascial Pain and Dysfunction
Search for information via the internet on trigger points and you will find many resources and pictures of the referral zones. Seek out a healthcare professional utilizing LiteCure Deep Tissue Laser therapy and discover the difference for yourself.