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Trigger points are otherwise known as trigger sites or muscle knots. Experts say that these points are hyperirritable spots located in the skeletal muscle that are somehow connected with palpable nodules in taut bands of muscle fibers. Those who practice in the art of trigger point think that palpable nodules are the obvious cause of pain due to the fact that they are tinny contraction knots. In situations where a compression of a trigger point occurs, local tenderness, local twitch response and pain may be elevated due to it. Muscle spasm and local twitch response is not the same thing and people should not mix them. Muscle spasm consists of an entire muscle contracting while in the case of the local twitch response only a twitch is present, never a contraction.

What are trigger points

Trigger points lead to the pain that is felt locally and there is almost always a referred pattern. The pattern is quite often seen with a musculoskeletal disorder that is almost never acute. The most often causes that lead to the development of trigger points are acute trauma or microtrauma that happen over and over again. These traumas lead to more stress on the muscle fibers and that is how mainly trigger points occur. When these points develop, a person will experience a regional pain that does not go away. In addition to this problem, a person will not be able to use the full range of the muscles that are being affected. Muscles that are responsible for the maintaining of the body posture like muscles in the neck, shoulders and pelvic girdle are affected in a majority of patients. Other symptoms of development of trigger points include tension headache, tinnitus, low back pain, decreased range of motion in legs and temporomandibular joint pain, among other things. In order for the pain that is felt due to trigger points to be reduced, palpation of the points is required. Apart from the palpation, there are certain modalities like Spray and Stretch technique, ultrasonography, manipulative therapy and injection that are being used in order for the trigger points to be inactivated. Injections are especially effective in inactivation of trigger points and a majority of doctors recommend them for this purpose.

How is trigger point therapy performed

The data claims that more than 23 million people in the United States suffer from one or more chronic disorder of the musculoskeletal system. These disorders are the leading cause of disability in the part of the population that is old enough to be working. When people of other age are considered, these disorders are in the very top of the causes as well. Probably the most often seen muscle disorder that occurred due to trigger points is myofacial pain syndrome.

When a person comes to the myofascial trigger point therapists complaining of pain caused by trigger points, the therapists will use myotherapy, mechanical vibration, pulsed ultrasound, electrostimulation, ischemic compression, injections, dry needling, Low Level Therapy and certain stretching techniques in order to relieve and treat the pain that occurred in the muscles due to a disorder of the musculoskeletal system. All of these methods are not used at the same time but it is not that unorthodox for a combination of some to be used on one patient. When performing these methods to place pressure on the trigger points, the therapists will not use their hands. Instead of hands they use elbows, feet or some tool to apply pressure.

Before any treatment can commence, the therapist first needs to identify the trigger points. After the identification the best possible treatment plan is made. That plan needs to settle the trigger points and restore normal range of motion in the affected muscles. However, this can only be done if all the trigger points are deactivated. When muscles are affected, the therapist will use muscle energy techniques, active isolated and proprioceptive neuromuscular facilitation or PNF in order to restore the length and full range of motion in them. The situations where muscles are not the ones that are being affected are not seen that often. In addition to the muscles, fascia that is located around the muscles should be treated as well. This is of great significance because if fascia is not treated the muscles will only go back to the positions where they were before the treatment and the trigger points will develop once again. Myofascial release is mainly used when fascia is being treated.

The skill level of the therapist is a significant factor in the way in which the manual therapy will end. The therapist neither must nor press the point neither too hard or too long nor too short. If that happens, the trigger points will remain active or become irritated. The muscle may even become bruised in some situations. Apart from these dangers, some more serious risks are possible as well like damage of the soft tissue and certain organs.

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