Trigger Point Therapy

What Are Trigger Points?

Trigger points are hyperirritable spots in skeletal muscle—tight bands or knots that are painful when pressed and can cause referred pain (pain felt in a different area). They're common in chronic pain conditions and can contribute to headaches, neck pain, back pain, and other musculoskeletal problems.¹

Characteristics of Trigger Points

Tender spots in taut muscle bands
Pain when compressed
Referred pain patterns (pain elsewhere)
Local twitch response when pressed
Limited range of motion
Muscle weakness without atrophy

Types²

Active Trigger Points

Cause spontaneous pain
Painful at rest
Refer pain when pressed

Latent Trigger Points

Only painful when pressed
Can restrict movement
May become active with stress

Common Locations

Upper trapezius (neck/shoulder)
Levator scapulae (neck)
Quadratus lumborum (lower back)
Piriformis (buttock)
Gluteal muscles
Temporalis (jaw/temple)

Treatment Approaches³

Manual Therapy

Ischemic compression (sustained pressure)
Myofascial release
Massage therapy
Stretching with spray and stretch

Needle Therapies

Dry needling
Trigger point injections
Acupuncture

Other Treatments

Ultrasound therapy
TENS
Laser therapy
Heat application

Self-Treatment

Foam rolling
Tennis ball or lacrosse ball
Massage tools (Theracane, etc.)
Sustained pressure for 30-90 seconds
Followed by stretching

What Causes Trigger Points

Muscle overuse or injury
Poor posture
Repetitive movements
Stress and tension
Lack of movement
Sleep problems

Prevention

Regular stretching
Good posture
Stress management
Ergonomic workspace
Regular movement breaks

References

Simons DG, Travell JG, Simons LS. Travell & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Lippincott Williams & Wilkins; 1999.
Shah JP, Thaker N, Heimur J, et al. Myofascial trigger points then and now: a historical and scientific perspective. PM R. 2015;7(7):746-761.
Cagnie B, Castelein B, Pollie F, et al. Evidence for the use of ischemic compression and dry needling in the management of trigger points of the upper trapezius. Am J Phys Med Rehabil. 2015;94(7):573-583.