Trigger Point Therapy

Based on many pioneering in the field e.g Janel Tavell and Dr Jay Shah and colleagues at the National Institute of Health we know that inserting a needle or manual therapy into a trigger point can cause favourable biochemical changes which assist in reducing pain. It is essential to elicit so-called local “twitch” responses, which are spinal cord reflexes, to get the muscle to relax. Getting local twitch responses with either dry needling or manual therapy is the first step in breaking the pain cycle.

Client receiving trigger point therapy to their foot.

Trigger Points

Myofascial (myo = muscle and fascial = spider web tissue surrounding muscle, bones and organs) Dysfunction is a muscle disorder characterized by trigger points. A Trigger Point is a small area of muscle that is in spasm (contracted), causing taut bands and hypersensitivity.

These so called “knots” in the muscle cause a restriction of the blood supply (ischemia) reducing the amount of oxygen (hypoxia) leading to the accumulation of metabolic waste products and toxins which sensitize the trigger point causing it to send out pain signals and further increase local and/or referred symptoms. Thus, the local physiology of a trigger point involves a vicious repeating pain cycle that needs to be broken.

Causes

A Trigger Point in the muscles or fascia tissues lead to myofascial pain causing an entire muscle to be painful, tight, weak, and more easily fatigued.

The cause is multi-factorial. It is built on a combination overworking or overstressing muscles, poor posturing, static or sustained postures, overuse, misuse, underuse and/or direct trauma of muscles.

Trigger Points can be either the cause or a contributing factor of a wide variety of painful conditions that you have.

Client receiving trigger point therapy to their calf
A diagram indicating trigger points located near the base of the head

Treatment

Your Physical Therapist will first palpate specific muscles to locate the pain producing Trigger Points that are found along the taut band (“knot”) in the muscles.

Once these are identified and confirmed as a source of your pain, they are treated with several methods of therapy that include, but is not limited to: Dry Needling, Acupressure (manual compression), Manual Therapy using Myofascial Release and Massage, Stretching, Moist Heat and a Home Exercise Program ( stretching, heat, etc.).

These forms of therapy are to De-Activate the Trigger Point to reset or relax the muscle, increase blood flow, and return the injured area to a more normal state (Homeostasis) of function. The root of the treatment is to identify the causes which lead to the development of these triggers points and correcting them.

After your treatment

This varies from patient to patient and from various conditions or problems you may have. Typically, it takes several treatment visits for a positive reaction to take place, especially if a chronic condition. Your Physical Therapist will set up a treatment plan of care based on your problems.

With Dry Needling, we are trying to cause a mechanical and biochemical change without using any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is broken and you begin to have pain relief.

A diagram indicating trigger points located near the shoulders and neck
This was the first time I have had Reiki and I loved it! I felt very peaceful and calm. I could feel and see a very bright light and afterwards felt very tired. I also felt tired the next day but since then I have had far more energy and feel really positive. I will definitely be seeing Violeta again as she is very calming and professional.
Justine, Bristol