Trigger Point Pain

Sometimes people report feeling tender or painful “knots” in their muscles. These can be places where trigger points have formed.

So just what is a trigger point?

By definition, a trigger pwoman X TrP points barebackoint is a hypersensitive, hyper-irritable spot or nodule, found in a taut band of skeletal muscle.

The good news is you don’t have to suffer from  trigger point pain. Massage therapy can definitely help to reduce and eliminate trigger points and the pain they can cause.

One way to think of a trigger point is as very small “nodules” or tiny pea or marble like knots where the muscle fiber has basically contracted onto itself in sort of a tiny, constant muscular spasm that is quite stubborn and refuses to relax.

Muscles and muscle fibers are meant to glide over each other as the body moves, extending or contracting. When in balance and not tight, muscle feels relaxed, not hard. But the tissue where a trigger point (aka: myofascial trigger point) is found, feels tighter and harder than the surrounding tissue.



 It is thought that repeated micro-trauma to an area of the body or muscle, or acute trauma, may play a part in trigger point formation. And micro-trauma’s may develop as the result of several factors including poor posture, inadequate nutrient/vitamin intake, joint problems and even sleep pattern disturbances.

man back neck painChronic muscular stress from work-related tasks or overuse leading to tight muscles can also contribute to the formation of trigger points within muscles.

Simple examples of this would be cradling a phone between the neck and shoulder, sitting for long periods of time in poorly designed chairs, or doing work that requires a lot of bending.

All can cause overworked and tight muscles leading to trigger point formation.

Post-surgical scars and adhered (stuck together) tissue as well as acute, repetitive stress sports injuries (tennis/golf elbow) can also lead to trigger points.

Trigger points are often found with those suffering from chronic musculoskeletal disorders.



You can have trigger points in many places in your body and not even know they exist … until you or someone else like a bodyworker or massage therapist comes across a tightened and tender area and presses on it.

TrP pain guyThe result? The trigger point … which had been lying dormant and inactive … becomes activated, tender and painful.

The pain can be very intense, feeling like a sharp dagger.

Or, it may not be sharp, but certainly can hurt. That is the one constant with treating trigger points … you will experience some level of pain to get rid of them.



Trigger point pain may also cause pain beyond the initially activated trigger point.

This pain – called “referred” pain – “radiates” or is sent along to other parts of your body. For example, a trigger point in your upper shoulder area can cause you to feel pain at the bottom of your neck, into your head or to the area of your eye.

TrP referred pain imageYou may or may not have experienced pain in a “referred” area before the trigger point was activated.

The image to the left is a classic trigger point referral diagram. For example, the areas where the highlighted blue dot shown is the main trigger point. The blue color around it is the associated pain referral pattern where you can also feel pain. The same goes for the other colors.

So the side benefit of releasing localized or specific trigger point pain is that referred pain areas can also experience pain relief.

Trigger points can tend to form in clusters in a muscle area or along a line or pathway. Where there is one, there are often others. Muscular tension, which can be caused by many things, can result in tight, contracted muscles over time. This continued contracted muscular state and/or the addition of more tension to the already tight muscle area, can result in the formation of trigger points within the contracted muscle.

As everyone is different, you may experience a different level or type of pain from trigger points. But the sensation of pain, sometimes to the point of being intolerable, is fairly universal when a trigger point is activated.

So, how do you get rid of trigger point pain?



Trigger point therapy is taught in many to most schools of massage therapy.  Granted, it is not extensive training, but gives students enough knowledge to provide a level of pain relief from trigger points.

There are also advanced education courses available for a massage therapist or other bodyworker to gain additional expertise in trigger point therapy. The greater the experience a trained therapist has in treating trigger points, the better the odds for a successful outcome are for trigger point pain relief.

TrP work on woman backBy working together, the massage therapist by palpating or feeling the area of muscle, along with feedback from the client as to pain level and intensity, locate the trigger point(s) and area(s) of pain.

Once isolated, the therapist uses a combination of finger and hand techniques to put pressure directly on the trigger point for approximately 20 seconds, and then gradually releases the applied pressure.

Depending on the trigger point, multiple pressure treatment applications may be needed for the taut, contracted tissue and trigger point to completely relax and release.  Until the trigger points is fully released and has broken down, the trigger point and pain can return. So patience, even in the face of pain, is important for the client to realize.

Those having multiple, very painful trigger points, patients may need to return for more than one visit to experience full relief from the pain caused by their trigger points.

Trigger point therapy is not comfortable, and often painful. However, many people look at it as a “good” pain” … for the pain is temporary, leading to ongoing relief after a full trigger point release … making the discomfort well worth it.

When it comes to trigger points, the phrase “no pain, no gain” is quite appropriate.



TrP reliefIn nearly all cases, the pain relief is immediate. In cases where there are fairly large or deep trigger points, it may take several visits to completely break them down which means complete pain relief will be delayed.

Depending on the depth and intensity of trigger point therapy received, you may want to apply ice or cold therapy (20 minutes at a time) to quiet down any resulting discomfort you may feel for a day or so.

Follow on heat therapy can be helpful in continuing to relax the muscle area worked on, and help increase circulation and nourishing the muscle with important oxygen, nutrients … as well as flushing the area of any residual toxins that may still be present in the tissues.

Hydration, in the form of drinking water, is always a good idea to stay hydrated and flush tissue toxins.



If you suspect that you have trigger points, have muscular pain you can’t explain and/or restricted range of joint motion along with some pain, you may have some trigger point involvement. Consider making an appointment with a massage therapist.

Trigger points can be the culprits behind several pain conditions, include headaches, back pain, neck pain, carpal tunnel syndrome, plantar fasciitis, and TMJ syndrome … or trigger points may be minor but still important contributing factors to these sorts of chronic pain conditions.

Unfortunately, some doctors may not recognize that trigger points as a prime cause of these conditions … instead prescribing pain medications that simply mask pain symptoms and not treat the root problem.



Speaking of doctor-assisted treatments, trigger point injections have become very popular the past several years, and people do report pain relief. But it may not permanent.

TrP injectionWe’re talking masking the pain with the injection of an anesthetic like Novocain/Procaine or Lidocaine.

The pain killing effects eventually wear off and the can pain and likely will return if the trigger point isn’t inactivated.

Some reports say the physical penetration of the trigger point nodule by the needle can inactivate the trigger point.

But again, as trigger points can be found in clusters, not always just one by itself, this could mean multiple injections at multiple injection sites … provided the doctor is highly effective at locating and isolating each trigger point.

And, there may be medical contraindications to injection with a painkiller, depending on other conditions the person may have … so those on multiple prescription medications for other diseases or conditions need to be aware of that.

Patients with a local infection, diabetes mellitus, those on steroids, anticoagulants or those or any with bleeding issues must consult with their doctor doing the injection to assess their suitability for same and any potential side effects.

Dry needling is another Western medicine technique … not at all related to Acupuncture or Traditional Chinese Medicine. A needle is used to penetrate and inactivate the trigger point and reduce pain, but with no injection used.



The body is a very complex creation, and unless you are well versed in anatomy, body systems, and other key physiological aspects … be very careful about trying to treat yourself … you could end up causing injury unnecessarily.

While there are books and tools that can show you how perform self-care trigger point therapy, it is always advisable to seek the services of a licensed and competent massage therapist. Besides, there are very few places on the body where you can use your own leverage for best results in attempting to treat your own trigger points … and you could hurt yourself in the process.

Theracane type product w womanSeveral products are available for “do-it-yourself-ers” including the TheraCane, Backnobber or BodyBackBuddy, which can be pretty effective. But be very careful of where and how much pressure you apply.

I like to use the example of brain surgery – you wouldn’t do it on yourself, right? Self-treating trigger points isn’t brain surgery, of course … but you can hurt yourself if you don’t know what you doing or aren’t careful.

Pressing into muscle and what else is there (blood vessels, etc.) … or compressing muscle tissue too hard or for too long can cause tissue or other injury

Massage Therapists are the experts when it comes to soft tissue and muscle pain, as are some other bodyworkers and complimentary holistic healthcare specialists. They have had special training to find and treat trigger points, and what methods to use in order to alleviate the trigger points and/or referred pain that you may experience.