What are trigger points (MTrPs) and where are they found?

1. A taut band or muscle fibers which are in constant state of contracture.

• MTrP formation occurs in order to protect or stabilize around site of potential or actual muscle damage or too much mobility at a joint.

• This could be due to tendonitis, whiplash, inflammation or injury to joint or nerve.

• May occur more often as a result of overload in eccentric muscle contractions.

• Can occur as result of inefficient, sustained postures that put abnormal stress on the soft tissues.

2. Common around arthritic joints.

3. Source of local pain and pain at a remote location.

• MTrPs elicit spontaneous and referred pain and pain is familiar when pressure is applied.

• Constant input into the nervous system which can alter motor control strategies, overload muscle or lead to disuse and weakness.

• This will perpetuate pain and cause what may be a mild irritation to be significantly painful.

Why are Myofascial Trigger Points detrimental?

1. Sustained contracture of muscle fibers causes local restriction in oxygen flow.

• This lack of oxygen may trigger an increased concentration of a key substance that potentiates the cycle of sustained muscle contraction.

• Low oxygen will also lower the pH at the site of the trigger point. This leads to release of several substances that trigger sensation of pain.

2. Lead to weakness without muscle atrophy

3. Source of chronic pain

• Muscle pain associated with MTrPs can create joint dysfunction creating potential for increased muscle pain as muscles have to meet higher work demand.

• Muscle pain can cause modified movement patterns and stiffness in order to protect the structure from further pain or injury. This leads to overall range of motion loss.

How are Myofascial Trigger Points and Myofascial Pain related?

1. Widespread pain is common in many syndromes such as low back pain and other chronic musculoskeletal conditions, whiplash, migraines, irritable bowel syndrome, temporomandibular joint (TMJ) disorders, and fibromyalgia.

2. While signaling to drive this pain occurs in the central nervous system, MTrPs are often involved in these conditions.  

Dommerholt J. Dry needling — peripheral and central considerations. The Journal of Manual & Manipulative Therapy. 2011;19(4):223-227. Gerwin RD, Dommerholt J, Shah JP. An expansion of Simons' integrated hypothesis of trigger point formation. Curr Pain Headache Rep. 2004; 8(6):468-75. 

File:Trigger Point Complex.jpg. (2018, April 2). Wikimedia Commons, the free media repository. Retrieved 03:33, December 4, 2018 from https://commons.wikimedia.org/w/index.php?title=File:Trigger_Point_Complex.jpg&oldid=295013182.

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