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What are Trigger Points?



Trigger points are discrete, hyperirritable spots located in the skeletal muscle. They produce local pain and referred pain. They often accompany chronic musculoskeletal disorders. A classic trigger point is defined as the presence of discrete focal tenderness located in a palpable taut band of skeletal muscle, which produces both referred regional pain and a local twitch response. Palpation of a hypersensitive bundle or nodule of muscle fiber of harder than normal consistency is the physitriggerpoint piccal finding typically associated with a trigger point. Palpation of the trigger point will elicit pain directly over the affected area and/or cause radiation of pain and a local twitch response.


The muscle may have ropelike or cordlike areas that vary in thickness from a string to a rope or cord. Trigger points areclassified as being active or latent, depending on their clinical presentation.


An active trigger point causes pain at rest, is tender to palpation with a referred pain pattern that is similar to the patient's pain complaint. This referred pain is felt not at the site of the trigger-point origin, but remote from it. The pain is often described as spreading or radiating.


A latent trigger point does not cause spontaneous pain, but may restrict movement or cause muscle weakness. The latent trigger points are more frequent than active trigger points. The patient presenting with muscle restrictions or weakness may become aware of pain originating from a latent trigger point only when pressure is applied directly over the point.  A local twitch response is defined as a visible or palpable contraction or dimpling of the muscle and skin as the tense muscle fibers (taut band) of the trigger point contract when pressure is applied or by needle penetration into the trigger point.


Trigger Point Injections, uses a small needle is inserted into the trigger point and a local anesthetic (e.g., lidocaine or procaine) along with a homeopathic solution to inactivate the trigger point and thus alleviates pain. Sustained relief usually is achieved with a brief course of treatment but there should be some relief at the time of the injection.  It is possible that the injection may cause a twitch or pain that can last a few seconds to a few minutes.