What are trigger points?

Jacob Teitelbaum
Integrative Medicine

Muscles are like springs. They take energy to relax and are naturally contracted. During the energy crisis that occurs in fibromyalgia, your muscles get locked in a certain position with tender knots called trigger points in the belly of each muscle. These then hurt when pressed on and can trigger symptoms at a distance. For example, irritable bowel syndrome and sinusitis, though often caused by the candida overgrowth, are also contributed to by an autonomic reflex from the trigger points.

Trigger points are small, localized areas in muscles and tendons that are very tender to pressure particularly in those with fibromyalgia.  These trigger areas are much more sensitive than other nearby areas.  In fact, pressure on one of the trigger points with a finger causes pain that causes the person to flinch or pull back when the areas are touched.  The actual size of the point of most tenderness is usually very small, about the size of a penny.  Trigger points are scattered over the neck, back, chest, elbows, hips, buttocks and knees, and 11 or more of these are found in most people with fibromyalgia.

In some conditions other than fibromyalgia, trigger point pain may also be felt in areas away from the actual tender trigger point.  For example, pain may seem to travel down one or both legs when trigger areas are pushed in the lower back.   This can mimic the pain of pressure on a nerve in the lower back from a ruptured disc, called sciatica.

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Trigger points are specific areas of pain and tenderness around your joints. Trigger points really hurt if someone touches them too. Fibromyalgia syndrome has multiple tender points or trigger points on both sides of the body. No one knows the cause of trigger points, and inflammation is not linked to the small areas of pain.
Trigger points might be "active" or "latent." An active trigger point is painful even when no pressure is applied to it, and the pain may limit the use of the muscle, leading to weakness and decreased range of motion. A latent trigger point does not cause pain during daily activities, but it will feel sore when pressure is applied to it, and may become activated if the muscle is injured.

Doctors aren't sure what causes trigger points. They may result from a single serious injury to a muscle or from repetitive minor injuries to a muscle area. Other possible causes of trigger points include poor posture, a vitamin deficiency, joint problems or maintaining an awkward body position. Trigger points are also common symptoms in people who have a condition called chronic myofascial pain (CMP), a neuromuscular disorder that affects the muscles and the tissue surrounding them (fascia).

Exercise, stress relief and over-the-counter medications like ibuprofen or acetaminophen can help relieve pain and inflammation from trigger points. If those measures don't work, a doctor can sometimes inject a pain reliever, a water solution or a corticosteroid directly into the trigger point. Botulinum toxin is also sometimes used for trigger point injections. Sometimes simply inserting a needle into a trigger point without injecting medicine into it can break the pain cycle and bring relief.
Trigger points are tender spots in muscles that are associated with fibromyalgia pain. According to the American Society of Rheumatology's older diagnostic criteria for fibromyalgia, if you have pain in 11 out of 18 trigger points tested, you fulfill the diagnosis. In the newer diagnostic criteria, trigger points are no longer required for diagnosis.

Trigger points are focal, hyper-irritable areas in muscle and connective tissue that are caused by muscle overload or overuse. The muscle tissue may feel tight like a guitar string or like a lump. Trigger points can cause a dull ache in the muscle that can be uncomfortable or very intense, or cause referred pain to other parts of the body, especially when pressure is applied. This referred pain can feel like a deep ache, which sometimes feels like a sharp or stabbing pain.

(This answer provided for NATA by Sarah E. Watson, MS, ATC, PES.)

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.