Table of ContentsView AllTable of ContentsTypes of Trigger PointsLocationTrigger Point CausesConditionsTreatmentSummaryFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types of Trigger Points
Location
Trigger Point Causes
Conditions
Treatment
Summary
Frequently Asked Questions
A trigger point is a taut band of skeletal muscle inside a muscle group that sometimes feel like little marbles or knots just under your skin. They can feel tender and cause pain at the trigger point location or elsewhere in the body.They can also limit range of motion and cause headaches, joint pain, eye issues, and a ringing sensation in the ears called tinnitus.
Trigger points are different from cramps, such as a Charley’s horse. The pesky points don’t cause an entire muscle to spasm, just a small portion of it. Treatment such as massage and “needling” may help reduce pain.
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Passive trigger pointshurt at their exact location. If you have a painful muscle knot in your hamstring and someone presses on it, the pain will be felt right where the pressure is on the knot.
Active trigger pointscause pain in that location as well as another part of the body. If someone presses on an active trigger point in your shoulder, you may feel pain in your shoulder along with symptoms in your chest or arm.
Trigger points 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. However, trigger points are most common in certain areas, including the:
Trigger points are formed when you injure your muscle or put continual stress on it. Stressors include:
Other factors may also contribute to the formation of trigger points, such as:
No one really knows why some people are more susceptible to trigger point-related pain. It’s also unclear what causes trigger point pain in general.
One theory is that trigger points become so tense that they limit blood flow to muscle tissue. This prevents oxygen and nutrients from reaching the muscle. Because the muscle needs them to heal, a cycle is created in which decreased circulation causes pain, which causes more decreased circulation. The cycle can be difficult to interrupt.
Conditions Associated With Trigger Points
The goal of treatment is to reduce pain associated with trigger points. This can be difficult due to the complex nature of musculoskeletal pain. While some treatments have been shown to be effective, there’s little scientific evidence that others help.
Medication
A healthcare provider may recommend medication to alleviate pain. Most often they’ll suggest painkillers such as nonsteroidal anti-inflammatory drugs, which include over-the-counter pain relievers like ibuprofen or aspirin.
Other medications used to treat muscle pain include:
Therapy
There are a number of non-pharmacological treatment options to reduce pain associated with muscle knots. Some of the most common are:
Applying manual pressure.This includes deep tissue massages or a myofascial release, which is a type of massage thought to help properly align the fascia surrounding your muscles. This can help improve circulation and normal movement of your muscles. You can also apply pressure on your knots yourself with a tennis ball, foam roll, or back-nobber.
Putting pressure on your trigger points temporarily cuts off circulation to the tissue, which raises levels of a chemical in the tissues called nitric oxide. Nitric oxide signals your body to open up microcapillaries (extremely small blood vessels), thus increasing blood flow to help break up the trigger point and end the pain cycle.
Dry needling.A healthcare provider inserts a needle into the trigger point and moves it in and out. This is considered one of the most effective ways to curb trigger point pain, but the area can feel sore after the procedure.
Trigger point injections.This is similar to dry needling, but in this procedure the needle contains a solution, most often a local anesthetic. Steroids are also an option, but there’s no scientific evidence that they help.
Spray and stretch.This is when a physical therapist applies a cold spray to the trigger point area and then stretches out the area.
Although it can be difficult to reduce pain associated with trigger points, a variety of treatment options are available. Your healthcare provider may recommend medication, physical therapy, massage therapy, or a form of therapy called needling.
A Word From Verywell
If you are dealing with painful muscle knots and trigger points, first, don’t panic. Trigger points are benign and pose no significant danger to you or your health. They simply cause pain which may limit your normal mobility.
To manage your painful muscle knots, check-in with your healthcare provider to ensure that there is no underlying sinister cause of your pain. Ask about physical therapy to help treat your trigger points, and start engaging in an active treatment program to make a positive difference with your trigger points. By learning strategies to self-manage your pain, you can be in control of your condition.
Frequently Asked QuestionsYes, trigger points are a taut band of skeletal muscle that feels like a marble under the skin. Trigger points are frequently referred to as knots.Yes, but not always. Trigger points are typically very sensitive to the touch and can refer pain to other parts of the body. Having several trigger points can result in widespread aches and pains sometimes referred to as myofascial pain syndrome.Trigger point therapy involves applying direct pressure to trigger points. This temporarily cuts off circulation to the tissue causing a build-up of nitric oxide in the tissue. Nitric oxide signals microcapillaries to open, increasing blood flow to break up the muscle knot.Yes, trigger point therapy can be painful, but only while pressure is being applied to the tender area. The temporary pain of trigger point therapy can help to relieve ongoing pain and muscle spasms.You may not feel immediate relief from a session but should feel the improvement the day after. It may take several sessions to fully resolve a trigger point. After each session, be sure to drink lots of water to help flush waste material from your muscles.
Yes, trigger points are a taut band of skeletal muscle that feels like a marble under the skin. Trigger points are frequently referred to as knots.
Yes, but not always. Trigger points are typically very sensitive to the touch and can refer pain to other parts of the body. Having several trigger points can result in widespread aches and pains sometimes referred to as myofascial pain syndrome.
Trigger point therapy involves applying direct pressure to trigger points. This temporarily cuts off circulation to the tissue causing a build-up of nitric oxide in the tissue. Nitric oxide signals microcapillaries to open, increasing blood flow to break up the muscle knot.
Yes, trigger point therapy can be painful, but only while pressure is being applied to the tender area. The temporary pain of trigger point therapy can help to relieve ongoing pain and muscle spasms.You may not feel immediate relief from a session but should feel the improvement the day after. It may take several sessions to fully resolve a trigger point. After each session, be sure to drink lots of water to help flush waste material from your muscles.
Yes, trigger point therapy can be painful, but only while pressure is being applied to the tender area. The temporary pain of trigger point therapy can help to relieve ongoing pain and muscle spasms.
You may not feel immediate relief from a session but should feel the improvement the day after. It may take several sessions to fully resolve a trigger point. After each session, be sure to drink lots of water to help flush waste material from your muscles.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L.Myofascial trigger points then and now: a historical and scientific perspective.PM R. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024Alvarez DJ, Rockwell PG.Trigger points: diagnosis and management. Am Fam Physician. 2002 Feb 15;65(4):653-60. PMID: 11871683.Celik D, Mutlu EK.Clinical implication of latent myofascial trigger point.Curr Pain Headache Rep. 2013;17(8):353. doi:10.1007/s11916-013-0353-8Jafri MS.Mechanisms of myofascial pain.Int Sch Res Notices. 2014. doi:10.1155/2014/523924Cao, Q.-W., Peng, B.-G., Wang, L., Huang, Y.-Q., Jia, D.-L., Jiang, H., Lv, Y., Liu, X.-G., Liu, R.-G., Li, Y., Song, T., Shen, W., Yu, L.-Z., Zheng, Y.-J., Liu, Y.-Q., & Huang, D. (2021).Expert consensus on the diagnosis and treatment of myofascial pain syndrome.World Journal of Clinical Cases,9(9), 2077–2089. https://doi.org/10.12998/wjcc.v9.i9.2077Desai, M. J., Saini, V., & Saini, S. (2013).Myofascial pain syndrome: A treatment review.Pain and Therapy,2(1), 21–36. https://doi.org/10.1007/s40122-013-0006-yAdditional ReadingOh, Sejun, et al. “Effect of Myofascial Trigger Point Therapy with an Inflatable Ball in Elderlies with Chronic Non-Specific Low Back Pain.”Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 1, June 2018, pp. 119–126., doi:10.3233/bmr-169696.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L.Myofascial trigger points then and now: a historical and scientific perspective.PM R. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024Alvarez DJ, Rockwell PG.Trigger points: diagnosis and management. Am Fam Physician. 2002 Feb 15;65(4):653-60. PMID: 11871683.Celik D, Mutlu EK.Clinical implication of latent myofascial trigger point.Curr Pain Headache Rep. 2013;17(8):353. doi:10.1007/s11916-013-0353-8Jafri MS.Mechanisms of myofascial pain.Int Sch Res Notices. 2014. doi:10.1155/2014/523924Cao, Q.-W., Peng, B.-G., Wang, L., Huang, Y.-Q., Jia, D.-L., Jiang, H., Lv, Y., Liu, X.-G., Liu, R.-G., Li, Y., Song, T., Shen, W., Yu, L.-Z., Zheng, Y.-J., Liu, Y.-Q., & Huang, D. (2021).Expert consensus on the diagnosis and treatment of myofascial pain syndrome.World Journal of Clinical Cases,9(9), 2077–2089. https://doi.org/10.12998/wjcc.v9.i9.2077Desai, M. J., Saini, V., & Saini, S. (2013).Myofascial pain syndrome: A treatment review.Pain and Therapy,2(1), 21–36. https://doi.org/10.1007/s40122-013-0006-yAdditional ReadingOh, Sejun, et al. “Effect of Myofascial Trigger Point Therapy with an Inflatable Ball in Elderlies with Chronic Non-Specific Low Back Pain.”Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 1, June 2018, pp. 119–126., doi:10.3233/bmr-169696.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L.Myofascial trigger points then and now: a historical and scientific perspective.PM R. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024Alvarez DJ, Rockwell PG.Trigger points: diagnosis and management. Am Fam Physician. 2002 Feb 15;65(4):653-60. PMID: 11871683.Celik D, Mutlu EK.Clinical implication of latent myofascial trigger point.Curr Pain Headache Rep. 2013;17(8):353. doi:10.1007/s11916-013-0353-8Jafri MS.Mechanisms of myofascial pain.Int Sch Res Notices. 2014. doi:10.1155/2014/523924Cao, Q.-W., Peng, B.-G., Wang, L., Huang, Y.-Q., Jia, D.-L., Jiang, H., Lv, Y., Liu, X.-G., Liu, R.-G., Li, Y., Song, T., Shen, W., Yu, L.-Z., Zheng, Y.-J., Liu, Y.-Q., & Huang, D. (2021).Expert consensus on the diagnosis and treatment of myofascial pain syndrome.World Journal of Clinical Cases,9(9), 2077–2089. https://doi.org/10.12998/wjcc.v9.i9.2077Desai, M. J., Saini, V., & Saini, S. (2013).Myofascial pain syndrome: A treatment review.Pain and Therapy,2(1), 21–36. https://doi.org/10.1007/s40122-013-0006-y
Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L.Myofascial trigger points then and now: a historical and scientific perspective.PM R. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024
Alvarez DJ, Rockwell PG.Trigger points: diagnosis and management. Am Fam Physician. 2002 Feb 15;65(4):653-60. PMID: 11871683.
Celik D, Mutlu EK.Clinical implication of latent myofascial trigger point.Curr Pain Headache Rep. 2013;17(8):353. doi:10.1007/s11916-013-0353-8
Jafri MS.Mechanisms of myofascial pain.Int Sch Res Notices. 2014. doi:10.1155/2014/523924
Cao, Q.-W., Peng, B.-G., Wang, L., Huang, Y.-Q., Jia, D.-L., Jiang, H., Lv, Y., Liu, X.-G., Liu, R.-G., Li, Y., Song, T., Shen, W., Yu, L.-Z., Zheng, Y.-J., Liu, Y.-Q., & Huang, D. (2021).Expert consensus on the diagnosis and treatment of myofascial pain syndrome.World Journal of Clinical Cases,9(9), 2077–2089. https://doi.org/10.12998/wjcc.v9.i9.2077
Desai, M. J., Saini, V., & Saini, S. (2013).Myofascial pain syndrome: A treatment review.Pain and Therapy,2(1), 21–36. https://doi.org/10.1007/s40122-013-0006-y
Oh, Sejun, et al. “Effect of Myofascial Trigger Point Therapy with an Inflatable Ball in Elderlies with Chronic Non-Specific Low Back Pain.”Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 1, June 2018, pp. 119–126., doi:10.3233/bmr-169696.
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