Trigger point in the upper back

What is trigger point?

A trigger point describes a taut band of skeletal muscle located within a larger muscle group. Trigger points are tender to the touch and can refer pain to distant parts of the body. Patients may have regional, persistent pain resulting in a decreased range of motion in the affected muscles. Trigger points are typically caused by mechanical factor, that is, factors that put strain or stress on your muscles. A spinal trauma, like whiplash from a car accident or a sports-related injury, can cause trigger points to form. It can also develop by doing repetitive and routine things every day that hurt your spine health over time. For example, you can strain your neck muscles by holding a poor posture for an extended period (like sleeping on an unsupportive pillow or craning your neck while working on a computer) or carrying a heavy handbag that burdens the muscles of your neck, upper back, and shoulders.

Types of trigger point

Trigger points are classified as either latent or active, depending on their clinical characteristics.

Active trigger points

• Typically cause pain at rest
• On palpation cause a referral of pain (pain is felt away from the site of the trigger point).
• The pain is typically described as “spreading”, “traveling” or “radiating”.

Latent trigger points

• Does not cause spontaneous pain.
• May limit movement or cause muscle weakness.
• You may not be aware that there is a trigger point until pressure is applied directly over the area.

Where do people get trigger point?

Trigger points and muscle knots can occur anywhere in your body. Wherever there is muscle tissue, there may be a small area of tissue tension. This could be a trigger point. Areas in the body where trigger points are the upper trapezius muscles on either side of your neck just above your shoulders. Other common side include:

• Quadratus lumborum muscles of your low back
• Hamstrings
• Calf muscles
• Along the iliotibial band.

You can get trigger points anywhere in your body, and if they occur excessively, you may experience chronic pain and myofascial pain syndrome.

Physiotherapy management

Trigger point therapy is a neuromuscular therapy designed to speed up recovery from injury, correct muscular imbalances, relieve pain, muscle tension and promote healing. There are many different physiotherapy treatments for trigger points. These may include:

• Posture training and education about postures and lifestyle.
• Passive stretching and/or Foam Roller stretching, few times a day.
• Strengthening exercises to help change your posture and the way your body moves, initially only isometric and then isotonic exercises.
• Taping Technique
• Some specific techniques like Neuromuscular Technique (NMT), Muscle Energy Technique (MET) and Myotherapy (MT),
• Ultrasonography, Hot and Cold packs, Laser, Ionophoresis
• Kinesiology taping
• Therapeutic modalities like ultrasound and electrical stimulation
• Dry needling -This therapy encourages blood blow to the trigger point muscle area, which may reduce muscle contraction.
• Massage
• Myofascial release technique is thought to help properly align the fascia surrounding your muscles. This can help improve circulation and normal movement of your muscles.

The pain of a trigger point may be extremely bothersome, and you may want to jump into an at-home fix immediately. But before you start any home therapy, talk to a trained professional—your doctor or physiotherapist to pinpoint the location of the trigger point so you can effectively treat it.