Spinal trigger points are hyperirritable spots located within a taut band of skeletal muscle or fascia along the spine. Sometimes referred to as muscle knots, these points are often painful when pressed and can cause referred pain, which is pain felt in a different part of the body than where the trigger point is located.
Trigger points differ from general muscle soreness because of their ability to send pain signals to distant areas.
Localized Tenderness: A palpable knot or bump in the muscle that is extremely sensitive to pressure.
Referred Pain: Pressing a point in the upper back might trigger a headache or pain down the arm, while a point in the lower back may mimic sciatica.
Twitch Response: A visible or palpable contraction of the muscle when the trigger point is snapped or provoked.
Reduced Range of Motion: Tightness in the muscle prevents full stretching, leading to stiffness in the neck or back.
Autonomic Symptoms: Active trigger points can occasionally cause localized sweating, tearing of the eyes, or a goosebump response in the referred area.
Because trigger points do not show up on X-rays or MRIs, diagnosis relies heavily on a physical assessment.
The goal of treatment is to release the taut band of muscle and restore normal blood flow to the area.
Compression: Applying steady, direct pressure to the trigger point for 30 to 90 seconds to encourage the muscle to relax.
Dry Needling: A clinician inserts a thin monofilament needle directly into the trigger point to elicit a twitch response and reset the muscle.
Trigger Point Injections: Injecting a local anesthetic, sometimes with a corticosteroid, directly into the knot to provide relief.
Spray and Stretch: Applying a cooling spray to the skin to distract the nerves while a therapist performs a deep stretch on the affected muscle.
Foam Rolling and Self Massage: Using tools like a tennis ball or a foam roller to apply pressure to hard to reach spots along the spine.
Postural Correction: Addressing the underlying cause, such as slouching at a desk, which places repetitive strain on the muscles.