Myofascial Trigger Point Therapy

A trigger point (1) is described as ‘a focus of hyperirritability in a tissue that, when compressed, is locally tender and, if sufficiently hypersensitive, gives rise to referred pain and tenderness’. The most commonly reported trigger points are sited in the muscles of the shoulder region (trapezius muscle) and the lower back (quadratus lumborum muscle) (1).

Treatment requires the ‘deactivation’ of the trigger point (TrP) and this may be achieved in a number of ways. A manual method for deactivation of trigger points involves the application of firm digital pressure which may be a combination of alternating pressure and release for up to 2 minutes. The pressure is thought to create a local ischemia which inhibits the neural activity maintaining the reflex, causing the associated taut band to release (2). Alternatively, muscles can also be released by inserting very fine (e.g. 0.25mm diameter) needles into the TrP which may help in relieving symptoms.

1. Travell JG, Simons DG. Myofascial pain and dysfunction: the trigger point manual, vol 2. Baltimore: Williams and Wilkins; 1992

2. Parsons, J. and Marcer, N. Osteopathy—Models for diagnosis, treatment and practice, Elsevier, Churchill Livingstone; 2005