Be Well: Pinpointing the Pain with Trigger Point Therapy

If you suffer from chronic pain, there might come a time when you think that you’ve tried everything and have to resign to living in constant discomfort. But practitioners of trigger point therapy say they can put their finger right on the source of your pain—and help ease it.

“Pain doesn’t have to be your normal,” says Spring Saldana, massage therapy program chair at Northwestern Health Sciences University in Bloomington.

In fact, she says trigger point therapy can help relieve that crick in your neck, frequent headaches, back pain, plantar fasciitis, and other chronic pain issues.

Saldana, BCTMB and CNMT, is board certified in therapeutic massage and bodywork, and certified in neuromuscular therapy. She describes a trigger point as a hyperirritable nodule or knot that can be found in connective tissue and muscle tissue in hundreds of places on the human body.

Those knots and nodules can restrict blood flow and keep nutrients and oxygen from getting to the area, causing waste buildup that, in turn, creates inflammation and pain. In trigger point therapy, practitioners find your trigger points and press on them to help the knot or nodule release, which can relieve your pain.

What’s interesting about trigger points is their ability to refer pain and symptoms to other parts of the body.

“There’s a little space between your neck and shoulder where vital things like nerves and blood vessels go through, called the brachial plexus, which supplies the nerves in the arm,” she says. “Sometimes the muscles of the neck and chest can pinch that bundle of nerves, and cause numbness or tingling and even pins and needles in your arm and hand, but it’s coming from the compression of the brachial plexus, higher up in your neck and shoulder.”

Some trigger points in the neck, head, and face can cause vertigo and dizziness, migraines, numbness or tingling in the face, toothaches, and TMJD symptoms. Trigger points in other parts of the body can cause back pain, irritable bowel syndrome, plantar fasciitis, carpal tunnel, and more.

Easing Up to the Trigger Point

In your initial appointment at Northwestern Health Sciences Bloomington Clinic, a certified neuromuscular massage therapist will discuss your pain and assess your posture and gait to see if you move freely or are putting weight to one side. That will help narrow down which trigger points might be causing your discomfort.

“If somebody has a high right shoulder,” Saldana says, “that tells me there are, between the shoulder and the ear on that side, probably some kind of trigger points, because posture is off.”

“That’s going to tell me which muscles are involved, which ones will be more tight,” she says. “I am going to look for trigger points in that area.”

When a new patient describes knots in certain areas, Saldana will palpate that area to assess the soft tissue quality and locate the trigger point(s).

After the intake and assessment, Saldana says treatment begins with a massage that works up to trigger point therapy. In other words, attacking the trigger point immediately and causing undue pain is not the goal.

“I would start out just working through the layers,” she says. “I would start with myofascial release, and then I would move into more Swedish strokes, working to a deeper level with those types of strokes. Once the tissue is ready, I would go into trigger point therapy.”

Will it Hurt?

“I don’t believe in no pain, no gain,” Saldana says. “There are some trigger point therapists that do believe that, but the body will guard against me if I try to go too hard too fast. It is important to work smarter, not harder. I want to get the most out of the treatment session by working through the tissue layers.”

Instead, Saldana doesn’t want to go past the client’s edge. Trigger point therapy treatment does not have to be painful. It may be uncomfortable, but it should stay at a “good hurt” intensity.

“I am going to get on that knot and apply static pressure,” she says. “If we stay at the client’s edge, which can be uncomfortable, but not cause pain, I can avoid causing guarding from the client’s body.”

Saldana will do a series of three presses on a trigger point with the intention of getting deeper and deeper into the tissue to alleviate pain and symptoms.

The goal is for long-term pain and symptom relief. Some pain can be relieved in a single session, while other chronic pain may take a series of treatments that tapers off as the pain diminishes. She says trigger point therapy helps reprogram the body’s muscle memory to keep pain away.

“It is definitely an effective and preventative type of bodywork that, when used correctly and done by someone who is certified, can save you money, because of surgeries and medical bills,” she says. “It can reduce pain and increase quality of life for the long term.”

View the original article from Mpls.St.Paul Magazine’s Be Well here.