Treating Pain with Myofascial Trigger Point Therapy

Techniques

Treating each trigger point is relatively simple. Treating the whole myofascial pain syndrome so that pain fully goes away is a more complicated process.

Since a trigger point is the contraction mechanism of the muscle (sarcomere) locked into a shortened position, the treatment of the trigger point involves unlocking that contraction mechanism. This can be achieved in several ways.

Manual compression involves applying gentle, direct pressure with the elbow, knuckle, thumb or fingertips to the trigger points causing the pain as well as to other trigger points in adjacent and related muscles. The pressure is held for a few seconds until the trigger point "releases" and the muscle softens. Sometimes a tool such as an Index Nobber can be used as well.

Spray-n-stretch technique, supplies energy in a small, focussed area to a trigger point in the form of non-thermal photons. This light is transmitted through tissue, with the light in the far-infrared wavelength penetrating the deepest, causing an anti-inflammatory as well as an immunostimulant reaction. Doctors have been using this for several years to enhance healing of injuries, but it has more recently become clear that this treatment is highly effective at deactivating trigger points. It is safe, painless, and causes no post-treatment soreness.

All of these are followed by gentle, passive stretch, reducing or eliminating pain, breaking the pain-spasm-pain cycle and fostering restoration of full function.

Along with treatment to release myofascial trigger points, your therapist will:

  • Take a full medical and pain history
  • Make a structural assessment to see if any inserts or pads may be helpful to reducing pain
  • Evaluate your pain map for referred pain patterns
  • Assess the ergonomics of your work station and other regular activities
  • Assess and make suggestions to improve the quality of your sleep
  • Make nutritional recommendations
  • Teach you gentle, rehabilitative stretches that will work with your lifestyle and abilities
  • Teach you to do self-treatment on your trigger points

Your therapist will show you exercises to safely and effectively stretch specific muscles for maximum efficiency of recovery, and prescribe a home rehabilitation program. If followed, you can expect steady improvement and also find you have a powerful tool for your own pain management.

Goals are set cooperatively with you at the initial session and are periodically reassessed. Your input, insight and creativity are highly encouraged.

What to Expect from Treatment

Trigger points are typically deactivated and eliminated within one to five low level laser treatments. Most people experience a noticeable amount of pain relief on the first treatment. Some trigger points become painless immediately, while others are more persistent and must be re-treated over a few sessions until they are gone. While it is common for patients to experience some soreness for one to two days after manual compression, there are no unpleasant after effects to cold laser therapy. After treatment, you may experience fatigue, as chronically tensed musculature is allowed to relax and return to a normal tone; however some patients experience an increase in energy. As the work-load of the musculature shifts and returns to a normal balance, pain patterns may change. This is a temporary and normal stage of recovery from chronic pain. It is not uncommon for people to experience relief from symptoms they were not seeking treatment for, such as chronic hand and forearm pain clearing up after being treated for a stiff neck. Returning to normal activities without pain is most often accelerated by adherence to the self-care program given to you by your therapist. Minimizing stress, pacing your activities and avoidance of overexertion (as well as focusing on what you can do instead of your limitations) are of prime importance. Good communication, patience and a positive attitude are essential.

Factors that Affect Rate of Improvement
  • Type and length of time injured
  • Overall physical health
  • Level of fitness
  • Underlying skeletal abnormalities
  • Nutritional intake
  • Quality of sleep
  • Depression or anxiety
  • Adherence to rehabilitative stretch plan
  • Other medical conditions (i.e. allergies, diabetes, thyroid dysfunction, etc.)