Manual Trigger Point

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Imagine having a small cut on your finger. One cut, one finger. It may hurt a bit, especially if something bumps the tiny cut or if you move your finger in just the right way.

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But the cut is nothing serious, and it is merely a temporary nuisance. Now imagine your entire hand and all your fingers have tiny cuts on them. These cuts are so numerous that they hurt, and hurt badly. And since the cuts are so numerous, every motion and some resting positions causes pain. This is myofascial pain syndrome.

Trigger Points: Diagnosis and Management - American Family Physician

You have so many tiny muscle and fascial trigger points that your body's muscles are constantly in a painful state. Myofascial pain syndrome can be difficult to treat; the pain is so widespread and so mysterious that it can be difficult to know where to start treatment.

How To Do Trigger Point Injections

Research indicates that no one really knows what the exact tissue is that makes you feel trigger points. It is also unknown why some people feel pain when touching muscle knots and some people do not. Today's science cannot explain why some trigger points hurt and some trigger points are simply muscle knots.

It is theorized that trigger points, the tight bands of muscle and fascia tissue, become so tense that the limit blood flow to muscle tissue. This creates a metabolic crisis in the muscle tissue; there are pain and tightness which requires oxygen and nutrients to help heal, but those nutrients are unable to get to the muscle due to decreased circulation because of the tightness. The pain-decreased circulation-pain cycle begins, and this cycle can be difficult to interrupt. There are two types of trigger points that physical therapists treat: active and passive trigger points.

Passive trigger points simply hurt at their exact location. If you have a painful muscle knot in your hamstring and someone presses on it, the pain will be felt right where the pressure is on the knot.

Trigger Point Therapy

An active trigger point refers to pain to another part of the body. If someone presses on an active trigger point in your shoulder, you may feel pain in your shoulder along with symptoms in your chest or arm. Regardless of the type of trigger point you have or the fact that we do not fully understand what is happening when trigger points form, you may benefit from physical therapy to help manage your problem.

If you seek out care from a physical therapist for trigger point therapy, do not go with the goal of eliminating your trigger points. Rather, focus on learning strategies to help manage painful trigger points. Myofascial release techniques and trigger point therapy may be helpful for your muscle knots and trigger points.

Myofascial release is thought to help properly align the fascia surrounding your muscles. This can help improve circulation and normal movement of your muscles. Trigger point therapy is performed by having your PT press and hold on top of the trigger points in your muscles. This temporarily cuts off circulation to the tissue. This cutting off of circulation increases a chemical called nitric oxide in the tissue.

Nitric oxide signals your body to open up microcapillaries, thus bringing in more blood flow and breaking the pain-spasm-pain cycle. One of the best things you can do for your trigger points is to learn to self-manage your condition. This may include performing self-massage trigger point techniques. These may include:. Research indicates that there is not one single best treatment for muscle knots.


One thing is for certain-engaging in an active treatment program of postural correction and exercise is superior to passive treatments for trigger points. Check-in with your physical therapist for a complete evaluation of your condition to learn about self-care strategies to manage your trigger points. If you are dealing with painful muscle knots and trigger points, first, don't panic.

Trigger points are benign and pose no significant danger to you or your health. Trigger point injections include an anesthetic. They also may use a corticosteroid or cortisone medication, which acts as an anti-inflammatory agent. Trigger point injections are one of many types of corticosteroid injections used to manage pain. Others include:. You will be moved to a recovery room and monitored by your care team. In most cases, trigger point injections are performed on an outpatient basis and you will go home the same day, although in rare cases some patients may require admission to the hospital following the procedure.

At the Henry Ford Pain Center , pain treatment begins with a thorough medical history and physical exam.

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All patients are evaluated by board-certified pain medicine physicians, physician assistants and certified nurse practitioners to identify the cause of their pain. Following initial assessment, we work with you to develop a personalized treatment plan that may include interventional pain procedures , medication therapy, physical therapy, massage and other complementary options.

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Not all appointment types at all locations are available online. Henry Ford Health System is committed to ensuring our Deaf or hard-of-hearing patients and visitors have equal access to all services. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and other assistive listening devices, at no cost. To request assistance, call or email CommunicationAccess hfhs.

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Trigger Point Injections Trigger point injections relieve knots of muscle that spasm and swell, causing pain.