A trigger point is a localised area of tightened, knot like tissue or hypersensitive area of muscle that can refer pain to another area.

Trigger points, pain and changes of tone in a muscle can be a result of either injury, overuse or emotional disturbances. It is interesting to think that trigger points can be traced back and related to an emotional response e.g a stress with work, personal life etc. If a person experiences a stressful event in their life there can be an alteration of the signals sent from the brain to the spinal cord meaning that normal sensations may be felt as pain.  

Increased stress and/or too much physical activity creates increased adrenaline levels 'the fight or flight hormone' which prepares us for danger/activity. If adrenaline levels are too high our body finds it difficult to relax itself and switch off to allow sleep.  Serotonin is normally produced when we sleep, it is a mood stabiliser and has a relaxing effect on us. Sleep disturbance means that we do not get as much serotonin produced and distributed in our bodies which leads to increased sensitivity and trigger points in the muscles. Ultimately a chemical imbalance of high levels of adrenaline and low levels of serotonin brings about increased tone/trigger points in our bodies. This may be a factor in contributing to fibromyalgia, M.E and other pain syndromes.

Trigger points can also create referred pain because a muscle receives information along the same nerve supply as another muscle, joint, or skin. Therefore, a pain felt in a certain point in the elbow may actually be a referred pain from a trigger point at the shoulder, as they share the same nerve supply and the body cannot always distinguish where the "pain message" originates. The brain only receives information that there is a sensitisation from a certain nerve supply and not  information from the exact structure at fault. However, we can normally distinguish which body part is normally affected by memory and experience.

Pain felt on one side of the body can also reproduce pain on the other side of the body. This is because there are neural connections between the sides of the body at each level of the spinal cord. Therefore a sensitisation of one side can sensitise the other side. 

Physiotherapy treatment can certainly help to treat triggers points in the body by de-sensitising and releasing these areas of increased tone by activating certain nerves which help to calm down the central nervous system. This brings about more normalised tissue response. In addition to the manual treatments for trigger points, acupuncture is also a very effective tool to manage this pain response and chemical imbalance.

For more information on acupuncture please check out our next post coming soon

Laura Dutton BSc(hons) MCSP MAACP
Physiotherapist