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We’ve all had one, a palpable “knot” in your neck muscles that hurts when you press on it, but “hurts so good” to have it massaged. Physical therapists call them myofascial trigger points, but what are they, how do they form, and how do you treat them?
In general, these trigger points are due to muscle overload over time, when muscle demand exceeds the capacity for the muscle to recover. This can happen from repetitive low-level chronic overload, like bad posture, or come from a quick maximal force that exceeds the muscle’s strength, like a whiplash injury.
When this overload happens, a group of muscle fibers gets stuck in a contracted position restricting blood flow to the muscle and causing painful inflammatory chemicals to build up inside the trigger point. This pain is both localized at the knot, but can also refer pain to other places. For instance, trigger points in the sub occipital region (base of the back of the skull) frequently refer pain up and around to the front of the head, causing tension headaches that are commonly mistaken for migraine headaches. This can happen all over the body, from the glutes and legs to the back and shoulders.
There are various ways to treat trigger points. Dry needling goes directly into the trigger point to cause a twitch response and release the knot. Massage and soft tissue mobilization can bring blood flow to the area and help “reset” the muscle. Exercise causes a rhythmic contraction and relaxation of the muscle to aid in restoring normal blood flow. Stretching and heat can also help promote healing.
Treatment strategies like this can take care of some of the symptoms of myofascial pain, but what about the underlying cause? Physical therapists are musculoskeletal experts who are specifically trained to find and treat trigger points, but treating the symptoms alone is insufficient to prevent them from returning. Often times patients suffering from myofascial pain also need to strengthen and stretch specific muscles to correct any imbalance that caused the trigger point to form in the first place. If you are unsure what may be causing myofascial pain in your life, make an appointment with one of our therapists and we will do a thorough examination to find the source of your symptoms and educate you on ways to reduce your pain and prevent the recurrence of chronic pain.