What are trigger points and why do I have them?

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If you've been in physical therapy in the last 10 years, you've heard of trigger point therapy.  And if you have  muscular pain and knots, then you most likely have trigger points.  Trigger points are hyper irritable spots in the muscle that's associated with hypersensitive palpable nodule in a taut band. The "spot" is very sensitive to touch and pressure.  It can also give rise to referred pain, muscle motor dysfunction and muscle weakness.  When the patient comes in with PAIN as their chief complaint, I first check to see where the muscle dysfunction is located, palpate the area, do a few orthopedic tests and start treatment based on those findings. 

 

When trigger points are treated with acupuncture, the immediate response is  a fasciculation in the muscle, like a crazy cool twitch response.  I wouldn't say it is painful, I'd describe it as a release in the muscle and it feels unexpected, maybe a little weird.  The pain relief should be immediate but that can vary depending on each patient.  Some patients really enjoy trigger point acupuncture because it is very effective in pain relief and restoring muscle function, but some may find it too aggressive.  Once you have started trigger point acupuncture treatments, its important to come in weekly to keep the momentum going for a short time (treatment schedule will depend on the severity of the injury).  We will also address neighboring muscles that were probably effected from the injury too.  It never really is just one muscle.

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What's actually happening physiologically to the muscle?

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- acupuncture needle insertion creates a micro-irritation the ischemic tissue

- this irritation creates a local histamine response (like a mosquito)

- blood flows to the area bringing an increase in fresh blood (nutrients and oxygen) to the nutrient starved tissue, which then cause vasodilation in the tissue

- an involuntary contraction of the affected muscle takes place, forcing the soft tissue to take a breath and relax!  The muscle is then returned back to its normal state.

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How do trigger points form?

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All kinds of reasons, there are many different ways to injure soft tissue, but I've listed the bulk of the causes:

 

- overwork (poor posture for you 9-5ers)

- repetitive motion

- direct trauma

- structural imbalances

- poor nutrition (hydration!)

- mental or emotional stress

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Post acupuncture trigger point therapy

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- drink a lot of water

- use a topical muscle pain reliever such as arnica, tiger balm, po sum on

- heat pack

- epsom salt bath

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** take it easy for the rest of the day, I'd stay away from working out especially in the area where we just treated

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