Physio trigger points show pain

Knubbel als Schmerzauslöser - How to treat trigger points

26/11/2014

Trigger points are often the cause of symptoms such as a leg pull, a stiff back, or headaches. „Muscles usually contract, then relax“, explains Walter Lieb, physiotherapist of the International Trigger Point Academy in Kaufbeuren. Muscles no longer relax, causing bumps in some places.

Tensions are usually caused by miscarriages or overloads, lack of exercise or, for example, sports injuries. „A common reason is also stress“, adds Cordelia Schott, orthopedist in Essen. Studies have shown that trigger points affect the pH value. So before the treatment, there is an overacidification, then it normalizes again. In addition, the presence of inflammatory and pain-promoting substances such as the so-called Substance P (P = Pain) is reduced. In addition, the trigger points according to recent studies also "related to the sympathetic nervous system." Trigger points are believed to shorten muscle and fascia fibers, causing pain or movement restrictions such as neck tension, back pain, headache on the back of the head, shoulder pain, or stiffness in the back while moving. "X-rays or MRI scans often do not indicate the causes, and the relationships between pain and trigger points are often unknown," according to the International Society for Pain and Trigger Point Medicine (IGTM)..

Studies have shown that trigger points affect the pH. So before the treatment, there is an overacidification, then it normalizes again. In addition, the presence of inflammatory and pain-promoting substances such as the so-called Substance P (P = Pain) is reduced. In addition, the trigger points according to recent studies probably related to the sympathetic nervous system. It is also believed that the trigger points can shorten the muscle and fascia fibers, causing pain or movement restrictions such as neck tension, back pain, headache on the back of the head, shoulder pain, or stiffness in the back while moving.

X-rays or MRI scans give no indication of the causes. Also, the relationships between pain and trigger points are often unknown, according to the International Society for Pain and Trigger Point Medicine (IGTM).

That the strained muscle bundles would often trigger the pain in completely different places was the case in four out of five patients. People who suffer from chronic symptoms such as heel spurs, tennis elbow, kneecap problems or headaches can therefore seek help from physiotherapists or osteopaths trained in the so-called fascial distraction model (FDM). You know the trigger points, such as between the arm and the neck.

Other frequently described symptoms related to trigger points are the upper bony muscle on the upper arm or the shoulder blade, the trapezius muscle, Schott explains. „This is the most common cause of headache“, so dear. „Many know the "question mark headache," which runs from the neck over the back of the head to the temple.“

„If you press a specific trigger point, it can also pull into the stomach or leg“, gives physiotherapist Ulrike Stocks-Sanio from Kaarst near Düsseldorf another example. It is important that those affected observe exactly where the pain takes place and how it feels, so that the therapist can use this information as the basis for the treatment. „Each muscle trigger point creates a typical pain pattern“, explains dear. The phrase "I know the pain, that's my pain," he hears more often from patients when he touches trigger points. In addition, stretching and strength tests would contribute to the diagnosis.

To dissolve the trigger points, the therapists then apply thumb pressure to the point in question. In doing so, they must hit the trigger points as precisely as possible so that the treatment is effective. As a result, the muscle then reacts with a decrease in tension, which is expressed in a tolerable pain lasting for 10 to 15 seconds. After three to four repetitions of the treatment, the potential was then exhausted. „So again comes fresh blood in this muscle strand, as nutrients and oxygen“, explains dear.
The goal is the resolution of the trigger points after a few hours.

Another possible therapy for the resolution of trigger points is the trigger point shock wave therapy, which resembles that with the thumb in its effect. „Also, acupuncture of the trigger point can be used with dry needles, the Dry Needling“, explains Schott. The trigger point therapy is a private medical service, which is usually not covered by health insurance companies.

According to experts, the therapy usually already after the first applications effect and the patients are first of all pain-free. However, the therapy is not an elimination of the causes, but only a treatment of the symptoms: „With the trigger point therapy, I only dissolve the hardening“, so Stocks-sanio. A lasting success of the treatment can only be achieved if the patient contributes accordingly, moves a lot and avoids stress. So advises Stocks-Sanio: „Also, one should remember while sitting again and again to sit straight.“ (Sb)