Although manual trigger point therapy can be painful, the pain should be described by the patient as a "good pain". The more precise the pressure on the trigger point is applied the less pressure is needed. I can easily regulate the pressure to your comfort level!
What are some possible causes of trigger points?
Stress, poor posture, slip and fall, auto accidents, poor ergonomics, repetitive motion, computer work, structural abnormalities, arthritis, nutritional deficiencies, disease processes, etc etc. Everything from being born to giving birth, being young, to being old, you name it! Moving too much, moving too little, no one is safe!
It's usually a form of overload on the muscle. That is very common in life, we all over do things, we all fall a few times in our lives. Childhood injuries to sports injuries, heavy lifting or packing, raking leaves of shoveling snow. Repetitive strain injuries (RSI) almost always are really trigger points.
Another potential cause is poor or awkward postures, especially combined with
repetitive movements, like you sometimes see in computer workers. A poorly set up work station can be a disaster waiting to happen. Driving for long periods, even seemingly simple things like knitting, beadwork, reading or drawing for long periods can really flair up trigger points and put you in a lot of pain!
You also see multiple trigger points in most musicians and other professionsals that must do a lot of the same thing for many hours.. Holding an instrument to practice or perform for eight hours a day, in the same position for hours is a way to get lots of trigger points.
What percentage of your clients present with some type of trigger point issue?
I would say 99 %. But that's partly because trigger points and pain management is
my specialty. Nearly everybody in the world has them and trigger points are
likely part or most of the picture for any musculoskeletal pain problem. That doesn't
mean they're the only cause of the pain, but certainly a contributing factor.
Among your client population, where do trigger points most commonly present?
They're everywhere. I think most people that I see have neck and back pain as their main complaint. People who work or play on computers have them in their neck, arms and shoulders. The diagnosis of plantar fasciitis or foot pain is almost always due to trigger points at the calf muscles.
Very often I find clients who simply want a massage. I will find trigger points that may not have presented with a specific pain complaint, but certainly once I treat them, even with a "massage" they can move more freely and they get off of the table with less pain.
Most of the people I see with neck and shoulder pain also have headaches, which we can address by treating trigger points in the neck muscles. Sadly, they, nor their doctors realize that the trigger points are the CAUSE of the headaches! In one study, 93 percent of migraine patients had active trigger points in the neck muscles compared to only 29 percent in the control group. That's a significant difference, yet very few Doctors, PTs or Neurologists even KNOW to look at a patient's neck muscles for the cause of the migraine or headaches.
If someone has trigger points, are they palpable to the doctor or therapist?
Let me start by saying that many people have found the trigger points on their own! They tell me about their pain and add, and there are these KNOTS.... Sometimes a friend has found them trying to give the person a "back rub". A massage therapist can find them during a massage too. But, I will say that only if the doctor or therapist has been properly trained will they know where to look or be able to find the trigger points that are the cause of someone’s pain. MOST of the time they are NOT where the pain is!
You have to learn how to palpate for trigger points. Not everyone can feel them. Once you learn the pain patterns and how to palpate, it's relatively easy. Once I point out the trigger points that are the cause of a person’s pain, they remember quite well where to look next time they have that same headache!
Feel free to use the wonderful symptom checker on the NAMTPT web site
If you are not in the Southwest PA or tri-state area, please check the directory at my professional organization's website to find a therapist near you. There is a directory listed under the heading of “find a therapist” or go here: http://www.myofascialtherapy.org/find-a-therapist/index.html
There is also a news letter that you can sign up for from the NAMTPT, click below: