Trigger Point

Trigger points can present themselves as referred patterns of sensation such as sharp pain, dull ache, tingling, pins and needles, hot or cold, as well as can create symptoms such as nausea, ear ache, equilibrium disturbance, or blurred vision. These small, hyperirritable sites in the muscle tissue sometimes refer pain to other locations as in headaches or sciatica.

To facilitate the identification of trigger points, you should be as relaxed as possible. Trigger points can be felt by palpating the muscles; trigger points will consist of tender, hard (or ropy) knots or nodules surrounded by what feels like normal muscle tissue. Once a trigger point has been found, the local twitch response may be elicited as muscle or skin twitching. You should feel sour or numb, but not knife-cut like pain when the trigger point is pressed. The trigger points are usually between or beside the bones and tendons or ligaments, on a depression, never on the bones or blood vessels. Next, the patient should be evaluated for referred pain.

Active and Latent Trigger Points

Trigger points can be classified as either active or latent. Active trigger points cause ongoing, persistent pain; latent trigger points are pain free until pressed. Both create a local twitch response when pressed. They are often associated with decreased range of motion, weakness in the affected muscle group, and decreased ability of the muscle to stretch. Often, active trigger points can cause "satellite," or secondary, trigger points in the reference zone that respond because of the increased stress to the involved muscle groups. For example an active trigger point in the back can create pain and eventually and satellite trigger point in the shoulder.  Treating the shoulder trigger point will not have a lasting effect without treating the originating trigger point in the back.

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