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What is trigger point therapy?

Trigger point therapy is a treatment for musculoskeletal pain that focuses on the identification and management of trigger points in the body.

Trigger points are thought to points in the body that are responsible for muscle pain, often in the area surrounding the trigger point but sometimes in other parts of the body – known as “referred pain”. The painful point can be felt as a nodule or band in the muscle and when pressed on by a therapist, the pain is reproduced.

The exact nature of trigger points is the subject of widespread scientific controversy. On the one hand, many massage therapists and chiropractors argue that “knots” in muscles can be felt in patients, and that the trigger points represent parts of the muscle tissue that are exceptionally tense. On the other hand, various studies have failed to demonstrate the existence of tense areas in muscles corresponding to the trigger points described by patients, when analysed on an MRI scan. Therefore others contend that trigger points are a problem with the nerves, which may become inflamed.

Either way, there is substantive anecdotal evidence that there are areas of the body which may feel tense, and that these seem to be responsible for localised pain.

How are trigger points diagnosed?

Because there is little medical understanding of the nature of trigger points, they are not generally diagnosable by medical professionals such as GPs or physiotherapists.

However, there are a number of practitioners of alternative medicine specialising in trigger point therapy such as massage therapists, chiropractors, osteopaths and acupuncturists. Each of these professions has their own methods of identifying trigger points but usually it involves feeling around the affected area.

The medical guidance in each profession varies. Some professions treat patients according to detailed “maps” which trace common links between trigger points and pain elsewhere.

How are trigger points treated?

Despite uncertainty around the nature of trigger points, it is possible to receive injections for trigger point pain in some pain clinics. These can involve the injection of steroids, botox or local anaesthetic to reduce swelling and improve symptoms.

Practitioners of alternative medicine have a wide range of strategies to treat trigger points. The aim is to release the tension in the affected area and manipulate the muscle back to its “natural” form. Techniques can include various forms of massage, vibration, electrostimulation, low-level laser therapy, or dry needling.