The term “trigger point” was coined in 1942 by American Physician Dr Janet Travell to describe a clinical finding with the following characteristics:
- Pain related to a discrete, irritable point in skeletal muscle or fascia, not caused by acute local trauma, inflammation, degeneration, neoplasm, or infection.
- The painful point can be felt as a nodule or band in the muscle and a twitch response can be elicited on stimulation of the trigger point.
- Palpation of the trigger point reproduces the patient’s complaint of pain, and the pain radiates in a distribution typical of the specific muscle harboring the trigger point.
- The pain cannot be explained by findings on neurological examination.
Travell’s work treating US President John F. Kennedy’s back pain was so successful that she was asked to be the first female Personal Physician to the President.
Studies estimate that in 75–95 percent of cases, myofascial pain is a primary cause of regional pain. Myofascial pain is associated with muscle tenderness that arises from trigger points – focal points of tenderness, a few millimeters in diameter, found at multiple sites in a muscle and the fascia of muscle tissue. Biopsy tests found that trigger points are hyper irritable and electrically active muscle spindles in general muscle tissue
Trigger points may be caused by a number of factors, including acute or chronic muscle overload, activation by other trigger points, disease, psychological distress (via systemic inflammation), homeostatic imbalances, direct trauma to the region, accident trauma (such as a car accident which stresses many muscles and causes instant trigger points) radiculopathy, infections and health issues such as smoking.
Trigger points form only in muscles. They form as a local contraction in a small number of muscle fibers in a larger muscle or muscle bundle. These in turn can pull on tendons and ligaments associated with the muscle and can cause pain deep within a joint where there are no muscles.
Injections, including saline, local anesthetics such as procaine (Novocain), and anti inflammatory medications such as Traumeel, can provide almost immediate relief and can be effective when other methods fail. A low concentration, short acting local anesthetic such as procaine 0.5% without steroids or adrenaline is recommended. Dry needling methods such as acupuncture and intramuscular stimulation (IMS) can also be effective but causes more post-injection soreness.
The perception of one’s health and wellness varies greatly among people. Some perceive it as whether or not they live in the absence of pain, symptoms or disease. The reality is that we are all able to maximize our health and wellness in many ways. We shouldn’t wait for some symptom, pain or problem to surface before we take action.
All of the therapies at the North Shore Wellness Centre can help you improve and maximize your Wellness Potential. Each of the therapies and therapists can help achieve this in many ways and we recommend you discuss this with whomever you see.
As practitioners we remind our patients not to wait until they are in crisis. Pain is often one of the last things to present, as people get tighter and lose more range of motion or function. Therefore, pre-active treatment, which usually involves getting assessed and treated even if you are not experiencing pain or other symptoms, is the best course of action to optimize health and wellness.
As a Chiropractor at the North Shore Wellness Centre, I recommend that people get in to see me, or Dr. Anita Hildebrandt, once per month to have us assess range of motion, muscle tightness and overall function. In virtually all cases we find stiff muscles and stuck joints in people who aren’t even experiencing any pain or symptoms. Furthermore, we find that these people feel dramatic improvements after their treatment. Many competitive and professional athletes make sure they get treated even more frequently than once per month, especially during their respective seasons, as they want to make sure their bodies are able to give them 100% of what they are capable of. A few degrees in increased range of motion may enable a faster skate/run/swim/etc with the associated enhanced functioning. Everyday people, like most of us, find that they’re able to do more and want to do more when they get checked out at a frequency of once per month like we suggest.
The reality is that we are all made up of moving parts, and the better we can keep these parts functioning, the higher the level of wellness we are able to achieve and the longer our bodies should be able to function at an optimum level. In addition, the better balanced and enhanced our joints, muscles and spines are – the better the brain is able to communicate with our other systems. All of the body’s organ systems rely on communication from the brain to function optimally and to enable the body to regulate and function as well as possible. By keeping the joints in the spine moving correctly we are able to achieve a higher level of Wellness because the brain and body are able to do their jobs more effectively.
So, please take our advice and get assessed and treated before the end stages of your body’s dysfunctions present themselves as pain or other symptoms! Improve and maximize your body’s Wellness on a regular basis! If you haven’t been treated for a month or longer we strongly recommend that you come in for an assessment today!