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Chronic pain is often identified as arthritis, bursitis, carpal tunnel syndrome, sciatica symptoms, tendonitis, Angina Pectoris, Myofascial Pain and Fibromyalgia. In many cases, however, a misdiagnosis is involved, and the pain is actually caused by trigger points in the muscles.

This can be diagnosed correctly and treated through trigger point massage therapy, given by professional massage therapists. Dr. Janet G. Travell, personal physician of US President John F. Kennedy, discovered and mapped out trigger points in 1942.

Trigger points are nodules that are contractions in bands of muscles that have tightened. The trigger points themselves cause local pain while simultaneously referring pain to other body parts. The referred pain is often located far from the trigger point. Painful trigger points that actively refer pain to other body parts are called active trigger points.

Your trigger points may not go away on their own, but that doesn’t mean you have to put up with them forever. Trigger point injections can also (TPI) provide immediate relief from muscle knots. Pain Science writes that trigger points are the gods of major gaps in medicine.

But the science of trigger points and myofascial pain syndrome is still weak and has yet to produce a proven way to treat pain. It’s all a bit half-baked … even after decades in the oven. Some serious, earnest experts have declared their annoyance with dogma and wild speculation about trigger points, and hype and big promises about treatments for them. The good news is Good trigger point therapy is hard to find but under-rated. It can be a safe self-treatment with the potential to help with many common pain problems that don’t respond well — or at all — to anything else. Done with care and humility, it’s worth dabbling in.

Trigger point massage therapists identify a patient’s trigger points and use deep prolonged pressure to deactivate then resolve them ( a bit like acupressure ). The therapist uses hands, fingers, knuckles, elbows, feet and many massage tools to apply and maintain such deep pressure consistently. After resolving the trigger points, the therapist works further on the muscles and fascia, using their natural range of motion to stretch, elongate and relax them.

According to the National Association of Myofascial Trigger Point Therapy ‘skilled practitioner who has been trained to recognize the symptoms of myofascial pain and palpate muscles for myofascial trigger points can assess whether myofascial trigger points are present. There are no commonly available lab tests or imaging studies that can confirm the diagnosis at this time. Myofascial trigger points can be seen on special MRI scans and special ultrasound but these are currently only used in research.

“Myofascial pain syndromes are muscle pain syndromes that are classified as musculoskeletal disorders. They have a defined pathophysiology that leads to the development of the characteristic taut or hard band in muscle that is tender and that refers pain to distant sites. MPS can be regional or generalized. If an MPS becomes chronic, it tends to generalize, but it does not become fibromyalgia. It can be classified both as a primary disorder without other medical illness or as a secondary pain syndrome that occurs as a result of another process. MPS may persist long after the initiating event or condition has passed, but it is nonetheless a muscle disease that can be satisfactorily treated.” Robert D. Gerwin, MD

A great detailed book on the subject which I have found really useful is ‘The Trigger Point Therapy Workbook: Your Self Treatment Guide for Pain Relief’, by Clair Davies, Amber Davies and David G Simons. It is dangerous to get trigger point massage therapy from an untrained therapist, though.

Trigger points will not be resolved if not enough pressure is applied or if it is not held long enough. If too much pressure is applied, on the other hand, or if the pressure is held too long, the trigger point may be bruised and this will lead to even greater pain. The untrained therapist may also cause the development of new trigger points or the activation of existing latent trigger points.

Other ways to try and reach trigger points yourself are by using a tennis ball, especially for sciatica pain.

A tennis ball basically apply’s the rules of massage, acupressure and reflexology which can help to relieve sore muscles and muscle tension. For sciatica pain, the tennis ball works on the piriformis muscle which is located close to the sciatic nerve. This muscle can push the sciatic nerve against the tendons beneath it which triggers the buttock pain and the pain down your leg. It presses and treats trigger points in the piriformis muscle which reduces the muscle tension and improves mobility and blood circulation to the area.

They say that it is also good for back pain as it acts as a massage to help reduce muscle tension and provide relief from lower back pain. Of course sciatica is a serious spinal problem so before you embark on any treatment for it you should check with your GP that this type of treatment would be of benefit to you.

I have previously had regular trigger point injections into my piriformis muscle which is done under x-ray in theater. I find this really helps my sciatica but doesn’t last long enough and as I can only have them three times a year, I have always been on the look out for something else to help with this type of pain.


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