The Root Cause Of Your Muscle Pain: Myofascial Trigger Points

Muscle Pain:  Myofascial Trigger Points

What Is The Myofascial Trigger Point?

The term “myofascial” comes from “myo”, which is the Greek word for muscle tissue, and “fascia” which is also Greek and refers to the connective tissues surrounding and throughout the muscle. Myofascial pain is a serious ailment suffered by many and often starts after muscle trauma or repetitive motion related sprain injury. Aching trigger points, similar to tightened knots in a muscle, can emerge because of the trauma or strain. These areas cause discomfort and reduce general muscle mobility.

Even though it’s not popularly known, a surprising number of patients are afflicted with myofascial pain and trigger points. While they’re known to be agonizingly uncomfortable, largely when pressure is applied, trigger points may also result in shortened muscle fibers. These aching points are also known to transfer pain signals to unrelated muscles in neighboring regions of the body. As an example, if a muscle in the upper arm contains a trigger point, then the muscle will send pain signals up your neck and into your head which registers in your brain as a headache instead of a shoulder ache. Myofascial trigger points are a regular origin of headaches that actually feel very similar to tension headaches or migraines.

What Causes Of Myofascial Trigger Points Are Most Common?

Trigger points are known to manifest because of several contributing circumstances. These circumstances include improper posture, muscle stress from repetitive movements, sleep issues, and insufficient nutrient levels. Myofascial Pain Syndrome or Chronic Myofascial Pain indicates that the unpleasant symptoms result from biological chaos created by myofascial trigger points. Often, this type of muscle soreness will present as secondary sources of discomfort or are mistakenly attributed to a completely different diagnosis.

These mistakenly diagnosed primary disorders include tendinitis, TMJ or other facial pain, carpal tunnel syndrome, bursitis, sciatica, arthritis, spinal disc pain, among others. Fibromyalgia is also very commonly diagnosed in these cases because the body aches are very similar to those experienced with myofascial trigger points.

Even though discomfort stemming from myofascial trigger points is frequently experienced by patients, the unfortunate truth is that the condition is omitted from the many modern medical training programs. Many of those seeking respite from discomfort are being treated with prescription drugs like muscle relaxers and anti-inflammatory medications that only treat the soreness and not the actual problem. It hasn’t been shown that these medications have any positive effect on the patient’s trigger points and really only serve to mask the soreness temporarily without eliminating it.

It’s encouraging, however, that more physicians are becoming increasingly mindful of myofascial trigger points and take the disorder into account when diagnosing their patients. Some doctors provide real options for relief, like trigger point injections, to patients while others refer patients to specialized Myofascial Trigger Point Therapists. Physicians who take myofascial trigger point pain into consideration and treat the problem properly enjoy high numbers of positive outcomes and extremely appreciative patients.

Where Are Myofascial Trigger Points Located?

The amount and location of myofascial trigger points will vary from patient to patient. Most people will experience multiple trigger points, though it’s possible for just a single point to be present. The symptoms of one will usually cause more to form. These points are capable of forming in all types of muscle tissues throughout the body. If the issue is not treated, each new trigger point can then cause additional discomfort and result in the emergence of additional trigger points. Most patients who experience pain will have more than a few muscles containing myofascial trigger points.

Physicians who received thorough training for identifying the symptoms of and physically examining muscle tissue for myofascial trigger points can determine if these points are present. Currently, tests and imaging techniques for finding or diagnosing myofascial issues are not available. Specialized MRI scans and ultrasounds do exist that can detect issues, though these tools are only available for research purposes.

What Are My Myofascial Trigger Point Treatment Options?

Treatment for myofascial trigger points is fairly easy, however, treating the total myofascial pain syndrome and fully alleviating pain can be a complex process. Treatment involves loosening the contracted muscles and releasing tension. One way to lessen the tension is for your physician to apply gentle pressure. Pressure applied in the correct way can massage the muscle to release the tension. There are many methods for executing this treatment and your doctor will decide which method is best for the muscle groups being treated.

Another method for treating pain related to trigger points is referred to as spray and stretch. Extremely cold liquid is sprayed on the skin at the affected area. The super cold fluid immediately evaporates, essentially distracting the muscle which allows for better stretching. The trigger point can be released after the muscle fibers are stretched and loosened. After being treated, the muscle can be moved across its full range of motion. The patient will need to continue with stretching and keeping the muscle lose at home as part of after care and general fitness routine.

What To Expect From Treatment

As with most conditions, treatment outcomes will vary from patient to patient. Some may achieve respite following the initial treatment while other patients may need several sessions before they begin to feel relief. Some muscle fatigue or discomfort for a day or two following the initial treatment sessions is normal. It’s also normal to experience a reduction in energy levels as the muscles adjust back to their regular, pain free status. Pain patterns will also change as treatment progresses and is an expected stage in the recovery process for chronic pain. Sticking with the after-care program after treatment will ensure you will achieve the highest level of relief as soon as possible. Controlling stress, avoiding overexertion, and maintaining your aftercare treatment program will ensure you feel relief.

Finding full relief from your symptoms will be dependent upon many factors and which other conditions you may have. Of course, your general health and level of physical fitness has a huge effect on how fast you will recover. Generally, a more fit patient will recover more quickly than a patient who is out of shape. Eating a nutritionally balanced diet and sleeping well have a positive result with the treatment and recovery process. If you suffer from other conditions, like skeletal abnormalities, depression, or anxiety, then you may have additional challenges with your rate of improvement. As with any program, your commitment to fully following doctors orders has the larges impact on the success of your treatment and recovery.

If you need assistance with any aspects of the self-care program, your physician will be able to make suggestions and provide guidance on the best way to proceed. While your physician will handle the physical treatment for releasing myofascial trigger points and will be able to prescribe appropriate self-care for you to continue at home based on taking a record of your complete medical history. One goal each patient should have is to increase the hours of quality sleep. Restful sleep allows your body to recuperate and recover during treatment. Lab results will determine if you’re nutritionally healthy and eating the proper foods. Be sure to discuss with your physician any issues you have and any aspects of the self-care program that you are unfamiliar with or are worried about.

Don’t hesitate longer than you already have. Seek treatment from a trained myofascial pain specialist now. Only you can begin down the path to complete pain relief, so get the help you need to stop your painful symptoms caused by myofascial trigger points today.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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