There are different ways to treat TrPs. The challenge comes from identifying the TrPs and being able to eliminate the entire myofascial pain syndrome.

 

A properly trained therapist can recognize myofascial pain syndromes and knows where to find trigger points, based on the information from the client’s history and symptoms, perpetuating factors, postural assessment and knowing the pain patterns.

There are no commonly available lab tests or imaging studies that can confirm the diagnosis of trigger points at this time. Trigger points can be seen on special MRI scans and special ultrasound but these are currently only used in research.

 

TrPs are physiological knots, meaning the contraction mechanism of the muscle is locked into a shortened position. Treating a TrP requires unlocking that contracted mechanism not just rubbing or relaxing it.

 

Ways to treat and eliminate TrPs:

​

1. Trigger Point Pressure Release (David Simons, MD and Janet Travell,MD) Hands-on technique.

• Applying direct pressure to the trigger point, with a finger, thumb, elbow or any other tool.

• Amount of pressure should be enough so the person feels the tenderness but not enough to be painful.

• The pressure should be held for several seconds until the trigger point “releases” and softens.

• Followed by stretching the treated muscles

 

​

 2. Spray and Stretch

• A technique that uses a a fine spray of vapo-coolant over the trigger point pain pattern.

• The spray evaporates as soon as it touches your skin. The coldness of the spray distracts the nerves without chilling the muscle, decreasing the pain sensation allowing the muscle to relax enough to be gently stretched, which helps to release the trigger point, relieve muscle spasm and eliminate the pain pattern.

• Followed by stretching the treated muscle.

 

​

3. Trigger Point Needling *​

• A technique in which a very thin needle is inserted into the palpated trigger point. When the needle is in the trigger point, the muscle will twitch, (feels like a quick muscle contraction), which is a sign that the trigger point was eliminated.

• Followed by stretching the treated muscle.

• Depending on the state, trigger point needling is within the scope of practice of many medical professionals including physicians, nurses, nurse practitioners, physician assistants, acupuncturists, physical therapists, dentists and chiropractors.

​

*Trigger point injections can be done with local anesthetic, saline solution, corticosteroid or botox. The dry needling is as effective as injection of any kind. The results come from the needle mechanically disrupting and inactivating the active TrP.

​