Explained: Trigger Point Therapies
What Are Trigger Points?
Trigger points are focal abnormal contractions in your muscles that can cause pain and muscle dysfunction. Trigger points can cause pain with certain movements, limit range of motion and cause pain radiation patterns to other body parts of the body away from the location of the actual trigger point itself. Trigger points are often sore or tender to the touch and palpation can result in muscle twitching.
How Do They Develop?
Trigger points can develop in muscles from acute or chronic stressors such as: acute injury, repetitive motion/overuse, postural stressors and psychological/emotional stresses. They can also develop around sites of prior surgeries, scars, or fractures. Trigger points are more likely to develop in tissue whose associated nerves are compromised by factors such as mechanical compression of the nerve, disc dysfunction, facet joint dysfunction, vascular compression, metabolic stress, biomechanical stress, postural stress, etc.
Why Do We Want to Deactivate Trigger Points?
When muscles develop trigger points, they remain tight, causing the compression of blood vessels, nerves and joint structures in that area. This results in pain, loss of range of motion with movement, and can even affect the normal function other adjacent tissues connected via the injured nerves or fascia. Deactivating trigger points can help restore normal tissue function, improve pain, and restore normal range of motion with movement.
How do you deactivate trigger points?
Trigger points can be deactivated in a variety of ways which fall into 2 general categories. All of these techniques are offered by different practitioners at Integrate, and some techniques you can even learn to do on your own at home:
Manual Deactivation – Trigger points can be deactivated by pressure, massage or other manual treatments by a skilled massage therapist, physiotherapist, or chiropractor. Your practitioner can even help teach you techniques to identify and treat your trigger points at home with pressure from your hands or a firm rubber ball.
Needle Deactivation – Trigger points can also be deactivated by directly needling the trigger point with acupuncture needles (dry needling) or with a needle attached to a syringe for liquid injection (trigger point injections). While these techniques cannot be done at home, they are a helpful adjunct to deactivate trigger points that are persistent, deep or otherwise difficult to access with manual therapies.
What is Trigger Point Dry Needling (TDN)?
Dry needling is a treatment technique which uses fine, filament-type acupuncture needles to release tight muscle knots or abnormal contractions in muscle with the goal of permanently reducing muscle pain and dysfunction.
What are Trigger Point Injections (TPI)?
Trigger point injections involve accessing a trigger point with a slim hollow needle for injection of a liquid such as saline or local anesthetic. The injection of fluid provides additional mechanical disruption of the abnormally contracted muscle fibres, which helps to promote resolution of the trigger point and any related pain or dysfunction.
How Does Trigger Point Deactivation (TPD) Work? Trigger point deactivation techniques works by:
Relaxing abnormal muscle contractions
Decreasing spontaneous electrical activity (which can lead to muscle contraction)
Restore normal muscle contractility and full range of motion
Desensitize tissues and deactivate sources of irritation
Promote bloodflow and self-healing
What Does TPD Feel Like? People experience different sensations with trigger point deactivation. Most people feel only mild discomfort or a mild “ache” as the needles are inserted. Patients sometimes feel a significant cramping sensation or a “twitch” response to insertion of the needle at a trigger point, but this is then followed by an immediate muscle relaxation and often improvement in their symptoms, pain and function.
Is There Research to Support the Use of TPD? Yes. Research has shown that there is increased spontaneous electrical activity as well as muscle fibre contractions at the site of an active trigger point. The electrical activity is kind of like “buzzing”, which causes the nerve-muscle connection to trigger the muscle to be tight when it’s not supposed to. Needling of trigger points has been shown to decrease or completely eliminate this spontaneous electrical activity by eliciting a twitch response in the muscle, which “resets” its electrical conduction system. In addition, new research has reported that trigger point needling can also reduce levels of inflammatory and pain-producing chemicals that are found at an active trigger point, ultimately reducing pain and dysfunction of the muscle, as well of the nerves and joints in its vicinity. This release can immediately improve range of motion, decrease pain and improve function.
How is TDN Different from Acupuncture?
TDN is a treatment that uses acupuncture needles, but that is where the similarity to acupuncture ends.
Trigger Point Dry Needling directly treats the neuromuscular system affecting muscle tightness, joint mobility, and symptoms of pain and irritation. It is thought that if you adequately release the muscle, the tissues are then allowed to assume normal function with improved neurological conduction and blood flow.
Acupuncture is a more superficial treatment that is based on the Traditional Chinese Medicine focus of restoring energy or “Qi” to the body. The theory is that blockages in our energy channels, or “meridians”, can be opened by properly placing needles along those energy channels at specific sites.
Is There Any Special Advice to Follow After a TDN Treatment?