History
Myofascial Trigger Points (MTrps) are well researched and have been recognised since the early 1900’s. Dr Travell, a cardiologist did a huge amount of research into this area, and her dedication to this cause resulted in a huge amount of knowledge into the area. Much modern research has been carried out and MTrps are now well recognised as a source of pain referral.
Definition
By definition MTrps are exquisitely tender points inside a taut band in a muscle. When palpated they can produce a local twitch response and when compressed or stimulated internally using a very fine dry needle they can produce a specific pain referral, and release the tightness within the muscle. When active these MTrps refer pain to other parts of the body. The areas to which each point refers are well researched and documented. See charts below.
Research
The mechanism by which this happens has also been extensively researched and only as recently as June 2007 a list of chemicals present in these active trigger points was discovered and published. These chemicals include acetyl-choline which is a neuro-transmitter substance which is normally used in the transmission of messages from the brain to the muscles. An over abundance of this can lead to hyper-activity within a muscle which is common in muscles with active MTrps.
Treatment
In our clinic we use manual therapy, deep pressure release, high dose Ultrasound, Laser therapy, stretching, Hold relax techniques, Deep Dry Needling and strengthening exercises to release these trigger points.
Chart below describes recognised pain referral pathways from Myofascial Trigger Points, we use these charts to explain the concept: