An important aspect of musculoskeletal pain and dysfunction is addressing all possible contributing factors, including the presence of joint or spinal dysfunction, postural imbalances, reduced coordination of movement, poor posture and the effect of trigger points.
Most muscular aches and pains are caused or affected by untreated “trigger points,” localized tender spots in muscles. Understanding and treating these points can lead to rapid and lasting pain relief. Trigger point therapy is a powerful tool in the management of both acute and chronic pain, including such common problems as headaches and back pain.
An active trigger point is a hyperirritable spot in skeletal muscle that is associated with a tender and palpable nodule in a taut band of muscle. These muscles often appear tight, weak, do not respond to just stretching and cause restricted joint ranges of motion. Once a trigger point is established it can become self-perpetuating and persist for decades until it is adequately released. If the trigger point is not released it can lead to altered joint motion and be the cause of recurring pain.
When pain is present muscles always go into a degree of spasm, this is a protective mechanism. So muscle pain is often not the primary problem but you still have to treat it to ensure a full and speedy recovery.
What causes a Trigger Point?
Trigger points are most commonly the result of overuse or trauma:
- This may be acute, e.g. sudden overloading of a muscle when having to take an unexpected weight.
- It can be gradual from chronic abuse of a muscle. This might be a repetitive strain, e.g. from typing, or from a postural problem such as rounded, hunched shoulders, or a weakness of the core stabilising muscles of the spine.
- Prolonged increased tension of a muscle due to a protective spasm from a facet joint sprain can also be a cause.
- In addition, Trigger Points may be secondary to some other pathology that may cause pain referred to a muscle. For example, a peptic ulcer may lead to Trigger Points in the deep abdominal muscles, which may persist long after the ulcer has healed.
Trigger Points seem to become more resistant after about 6 months, and chronic Trigger Points usually need prolonged therapy and exercises, alongside your Physiotherapy care. The correction of hormonal, nutritional and postural problems may also be an important part of treatment.
The frequency of visits is determined by your problem and how quickly you respond to the Physiotherapy treatment program.
From there Joshua moved down to Geelong for 3 years at Geelong Hospital working in intensive care, surgical, respiratory and orthopaedic physiotherapy.