A trigger point is an area of the muscle where normal physiologic activity has become disrupted, causing local pain and sometimes in an adjacent area. I (Tom) frequently see that trigger points in the sternocleidomastoid (SCM) muscle at the front of the neck responsible for causing headaches on the side of the head. Trigger points also can reduce the normal range of motion in a muscle or cause it to be weak.
Trigger points can be caused by overuse or continuous contraction of a muscle, poor posture, traumatic injury, and even emotional stress. Let’s say for example, that when you sit at your computer, you are continually gripping your mouse. The muscles involved in this action stay shortened an unnatural length of time, and this creates trigger points that may produce carpal tunnel syndrome.
The only diagnostic test for a trigger point is palpation. When examining through touch the muscles that might be involved, a nodule (tightly bound area) or taut band of tissue is found to be exquisitely tender, evoking a response of recognition- as in, “yes, right there.”
Anatomy of a Muscle
A muscle contains many muscle fibers or cells that runs from its origin to its insertion. A nerve axon is attached to each muscle fiber. The area of attachment is known as the motor endplate or motor point. Motor points are usually found in the body of the muscle. Normally, the neurotransmitter acetylcholine is released at one end of the motor endplate across the neuromuscular junction, to connect the muscle fibers, but where there is a trigger point, no acetylcholine is making the jump. Acupuncture with electrical stimulation invigorates this mechanism, effectively restarting it and knocking out the trigger points.
Most trigger points are usually found in the body of the muscle or at its origin or insertion. Every muscle has an origin and an insertion. The origin of a muscle attaches to a bone and does not move that bone. The area of insertion is where the muscle attaches to another bone, and when the muscle contracts, the insertion area moves closer to the origin. Muscles usually crosses a joint, this is what allows muscles movement.
Most trigger points are near motor points, and interestingly, a lot of acupuncture points are also located on or near motor points.
Trigger Point Types
There are two types of trigger points, active and latent. An active trigger point is the full manifestation of symptoms, from local and referred pain, to muscle weakness. A latent trigger point may show as loss of range of motion to a muscle, and may be accompanied by some local tenderness in the muscle.
Here’s where it gets tricky and why it’s important for an experienced practitioner to assess your problem: active trigger points can set off latent trigger points in the same area and become active, and this cascading effect can cause much discomfort. The aim is to knock them all out with treatment, not leave some behind!
A patient came into my office complaining of sciatica pain down the back of her leg. I had her lay face down on the table, and proceeded to palpate her lower back and gluteal muscles. I found a taut band and exquisitely tender knots on her gluteus minimus muscle that elicited the pain that she had been feeling down the length of the leg. Based on experience, I knew it was a trigger point problem, and treated this muscle with acupuncture and electrical stimulation. The sciatic-like pain was gone after 3 treatments of releasing the trigger point and allowing her neural pathways to adjust.
Trigger points do affect the quality of our life in one way or another, but this does not have to be, for they can be treated easily and affectively with acupuncture. One way to prevent trigger points is through injurious habits. Be aware of repetitive movements at work and play that put unnecessary stress on muscles: this includes postural habits you may not be aware of.
It is important to see a western doctor for tests to rule out the origin of the pain, because trigger points sometimes mimic other conditions. Diagnostic tests for pinched nerves, slipped discs, or arthritis can determine if there is another underlying problem.
Why suffer with physical pain if you don’t have to? Put yourself on a pain-free path by taking care of you, through by proper exercising, diet, and receiving bodywork when needed. Be well!
If you have questions and concerns about acupuncture treatment, we offer a free 20-minute phone session: click here for contact information to call or e-mail us. We practice at The Highlands Ranch Medical Pavilion in Littleton, Colorado.
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