Trigger points (TrPs) are hypersensitive nodules in tight bands of skeletal muscle that cause motor and sensory dysfunction and often elicit pain. The most accepted theory describing the cause of Trps suggests that these nodules are the result of abnormally contracted sarcomeres (the smallest functional unit of skeletal muscle fiber) which are influenced by structural and biochemical factors.

Fast Facts:

• TrPs can be active (causing persistent pain and immediate restriction of movement) or latent (may not elicit pain until pressure is applied but still contributes to muscle weakness and limited range of motion.

• TrPs are palpable and usually range from the size of a pinhead to a pea

• TrPs often cause referred pain to other areas of the body which limits mobility and causes muscular compensation. This can cause a compounding effect by activating other TrPs along the kinetic chain creating what is knowns as “satellite trigger points”

• Manual pressure on TrPs can bring blood flow to the area and encourage the fiber to relax. Bodywork is always more effective when followed by corrective exercises and stretches to help reorient healthy movement.

References

Haleema, B., & Riaz, H. (2021). Effects of thoracic spine manipulation on pressure pain sensitivity of rhomboid muscle active trigger points: A randomized controlled trial. JPMA. The Journal of the Pakistan Medical Association, 71(7), 1720–1724. https://doi.org/10.47391/JPMA.02-256

Jin, F., Guo, Y., Wang, Z., Badughaish, A., Pan, X., Zhang, L., & Qi, F. (2020). The pathophysiological nature of sarcomeres in trigger points in patients with myofascial pain syndrome: A preliminary study. European Journal of Pain (London, England), 24(10), 1968–1978. https://doi.org/10.1002/ejp.1647

Shipton, B., Sagar, S., & Mall, J. K. (2023). Trigger point management. American Family Physician, 107(2), 159–164.