TRIGGER POINT THERAPY

Treatment of myofascial triggerpoints

Trigger Point Therapy is a manual therapeutic treatment concept within physiotherapy, which is based on the fact that many pains and functional disorders of the musculoskeletal system have their origin in the muscles. It aims at influencing so-called myofascial trigger points and their symptoms, as well as specifically treating the associated morphological changes of connective tissue. In this context, the term myofascial refers to the muscles and fascia.

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Active and passive trigger points

It is not only about the treatment of affected muscles and pain, but also about influencing pain management processes in the nervous system. A distinction is made between so-called active trigger points, which show a clinically relevant pattern of pain when movement stimuli are applied, and latent trigger points, which are clinically silent, i.e. they are not known to the patient from his everyday life, but only become apparent when strongly provoked by pressure or traction, often in the form of radiating pain.

Causes

In the development of myofascial trigger points, those zones within the muscles are relevant which suffer from a reduced blood flow or oxygen deficiency due to poor posture, lack of exercise, stress or acute, as well as chronic overloading. The lack of oxygen leads to a disturbance in the muscular energy metabolism, in which the structures involved in the muscle contraction are no longer able to separate from each other and consequently remain in a contracted state.

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Referred pain

The affected muscle cells feel like knots that can easily be palpated by the physiotherapist and react very sensitively or even painfully to pressure. They often radiate into other parts of the body. In this case one speaks of so-called referred pain, i.e. the place where the pain is felt is located further away from the place where the pain originates. Headaches, for example, might be caused by trigger points in the neck muscles.

Symptoms

Furthermore, trigger points can also cause paresthesia (tingling, numbness, burning, altered temperature sensation), pain-related weakening of the affected muscles, movement limitations, muscle shortening, edema, circulatory disorders, or coordination disorders during muscle activation. Vegetative reactions such as dizziness, nausea, increased sweating and an increased skin temperature in the affected area also occur.

Manual techniques

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In Trigger Point Therapy, various manual techniques are used to reflectively influence the affected tissue. Some examples are muscle stretching, post isometric relaxation, muscle energy techniques, or myofascial relaxation techniques. In addition, various manual compression techniques and fascial techniques are used.