Trigger points are very common and often become a painful part of everyone’s life at one time or another. The severity of symptoms that result from trigger points ranges from incapacitating pain caused by active trigger points, to the painless restriction of movement caused by inactive trigger points.
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Muscles develop myofascial trigger points (TrP) in reaction to stress. These stresses often involve biomechanical overload on the muscle, but could also result from chemical stimulants such as caffeine, excess heat or cold, nutritional deficiencies, or psychological stress. Referred pain created by a TrP increases muscle tension either in the muscles housing the TrP and/or in the pain referral zone. Muscles that perform the same action as an injured muscle can also develop TrPs while compensating for the dysfunction.
Excess muscle tension is the most common muscular dysfunction. Despite its frequency of occurrence, this problem rarely receives the level of attention it deserves. Perhaps the idea of tight muscles is too simple to be considered an orthopedic condition. However, biomechanical disturbances around various joints are routinely described by researchers and clinicians as muscle imbalance and tightness. Muscle tightness results from an increased rate of contraction stimulus causing the muscle to hold a higher degree of resting tonus than it normally would. Some form of stress generally creates this degree of increased tone. Types of stress primarily responsible include mechanical (e.g. postural distortions), chemical (e.g. excessive caffeine intake), or psychological. The body’s response is to increase neuromuscular tone in reaction to the stressor.
Constant tensional force in a muscle pulls on bones and structures. As a result body segments get pulled out of correct alignment. Poor posture and constant tension cause muscles to become ‘loaded.’ This means that they begin playing the structural role of bones, providing structure and support for the area and the rest of the body. Eventually these muscles become fatigued from overuse and other muscles become weak from disuse. The nervous system functions in overdrive and a cycle of pain occurs, leading to musculoskeletal dysfunction. Musculoskeletal dysfunction may result from nearly any activity, and in some cases, inactivity. The two most common patterns occurring as a result of soft tissue dysfunction are sustained hypertonicity (continuous muscle tightness of a muscle or muscle group) and sustained inhibition (continuous muscle weakness of a muscle or muscle group). Contracted, or tight muscles, displaces the structure of the bones as fascia torques and twists. The soft tissue pattern continues to tighten or loosen, responding to the various segments being pulled out of correct alignment. Since soft tissue components have such a great influence over bones, causing poor posture, articulating surfaces ultimately undergo chronic compression. This generally leads to adverse changes in articulating surfaces because the joints are compressed.
It is thought that the likelihood of developing pain-producing active trigger points increases with activity into mid-life. As activity becomes less strenuous, individuals are more likely to be aware of the stiffness and restricted motion resulting from latent trigger points.