Trigger points follow specific nerve pathways and are accountable for many unexplainable nerve problems, including nerve tingling, pain, and numbness. This applies to both the sensory and motor nerves. Yet, very few physicians are competent in this field of medicine. Why? This science is actively being taught in Naturopathic, Osteopathic, and Chiropractic Medical Schools. This may be the reason: The nerve problems cannot be explained on a neurological exam. A physical exam is also useless for diagnosis. Therefore, many doctors dismiss their patient’s complaints as it must all me in your head. Understanding trigger points takes persistence and courage on the doctor’s part. Far too many doctors are in too big of a hurry.
The following are all very well documented FACTS:
1) Trigger Points are Muscle Knots, palpable nodules of taut bands in muscle fibers.
2) There are over 620 potential trigger points possible in the human muscles. This is well documented and is actively taught in Naturopathic, Osteopathic, and Chiropractic medical schools. It is one of the primary principles taught at all Frequency Specific Microcurrent training seminars for licensed physicians. Trigger points are also widely recognized by many other branches of medicine.
3) Trigger point pains cannot be explained by findings on neurological examinations.
4) A 2009 review of NINE studies examining the reliability of trigger point diagnoses found that physical examination could NOT be recommended as reliable for the diagnosis of trigger points. Reference: Lucas N. Macaskill P, Irwig L, Moran R, M Bogduk N (2009 Jan) Reliability of physical examination for diagnosis of myofascial trigger pints: as systematic review of the literature.
5) Trigger points is a hyperirritablity in muscle that can strongly modulate the central nervous system functions. (See: Memory, Pains, & Serotonin in the next topic.)
6) Biopsy tests found that trigger points were hyperirritable and electronically active muscle spindles in general muscle tissue.
7) All Trigger Points follow nerve pathways. This explains why a trigger point in one area, can affect a distant area. A trigger point is defined as a tight muscle knot that is pressing against a nerve at any point, in its path to a distant location. This is why over 620 trigger point locations have already been accurately mapped out.
8) Key trigger points are ones that give a pain referral along a nerve pathway that activates a latent’ trigger point of the same pathway, or creates one.
9) Satellite trigger points are activated by a key trigger point.
10) Primary trigger points in many cases will biomechanically activated a secondary trigger point in another structure. Treating the primary trigger point doesn’t treat the secondary trigger point.
11) Collision trauma such as a MVC (car crash), stresses many muscles at the same time and causes instant trigger points.
Trigger points form only in muscles. They form as a local contraction in a small number of muscle fibers in a larger muscle or muscle bundle. These in turn can pull on tendons and ligaments associated with the muscle and can cause pain deep within a joint where there are no muscles. The integrated hypothesis theory states that trigger points form from excessive release of acetylcholine which produces sustained depolarization of muscle fibers. These sustained contractions of muscle sarcomeres compresses local blood supply restricting the energy needs of the local region. This crisis of energy produces sensitizing substances that interact with some nociceptive (pain) nerves traversing in the local region which in turn can produce localized pain within the muscle at the neuromuscular junction (Travell and Simons 1999). When trigger points are present in muscles there is often pain and weakness in the associated structures. These pain patterns in muscles follow specific nerve pathways and have been readily mapped to allow for identification of the causative pain factor. Many trigger points have pain patterns that overlap, and some create reciprocal cyclic relationships that need to be treated extensively to remove them.
There are two basic types of nerve fibers. A) Afferent or Sensory nerves. B) Efferent or Motor nerves.
1) Sensory nerves have to do with touch, feel, hot, cold, etc.
2) Motor nerves are for motor functions such as raising your arms and hands, or walking, etc
Sensory nerves are affected in three ways, if the nerve is somehow compromised.
1) Tingling. This is common and is not serious.
2) Pain: This can be very painful and is considered serious.
3) Numbness: This is by far the worst symptom. This is very serious and indicates significant damages have occurred for some reason, somewhere. If the numbness is not sufficiently diagnosed and treated, it can become permanent.