TRIGGER POINTS
MYOFACIAL PAIN
The muscles are very often responsible for pain.
Although pain of muscular origin is common, it is often not recognized as such.
The place where the pain is felt is often far from where the pain originated. This is the reason why the muscular causes of pain are often overlooked.
Thus, the origin of back pain is sometimes in the abdominal muscles and headaches can come from the muscles of the neck.
In many patients, the cause of epicondylitis must be sought in the muscles of the neck and shoulder. Leg pain is often caused by the gluteal muscles, and pain in the Achilles tendon often originates in the calf.
TRIGGER POINTS
Myofascial trigger points are hypersensitive areas located in the musculature, the palpation of which can trigger disorders known to the patient. What is characteristic of trigger points is that the pain felt in one area can radiate to another area: trigger points present in the gluteal muscles cause pain in the entire leg, up to the foot .
From a medical point of view, trigger points are microscopic areas located inside a muscle, in which certain fragments of muscle fibers are contracted and can no longer relax. The bundles of contracted muscle fibers cause, on the one hand, a loss of function of the muscle, and on the other hand, a compression of the extremely fine blood vessels which irrigate the muscle. The affected muscle areas (=trigger point) are then less well irrigated and therefore no longer receive the quantity of oxygen necessary to function properly. A vicious circle ensues.
The objective of trigger point therapy is to loosen the affected muscle areas and stretch them by separating them in order to improve and normalize irrigation and local oxygenation. In most cases, this can be done, even when the trigger points have existed for several years.
THE TREATMENT
IMTT Manual Trigger Point Therapy is a systematic therapy concept that takes place in 6 steps: 4 manual techniques.
They are complemented by measures that stretch and relax the muscles and contribute to strengthening them.
This therapy can be conducted by physiotherapists and doctors who have undergone special training.
The collaboration between the physiotherapist and the patient is very important. Therapeutic work can trigger pain that the patient knows and which can often be unpleasant. It is up to the patient to say “stop” when the pain becomes unbearable.
After treatment, pains that are familiar usually decrease and mobility increases. On the other hand, the areas of the body that have been treated may be red and locally a little painful for 1 to 3 days.
The patient can support the healing process by performing exercises to do at home specially adapted to his pathology (stretching, posture, strengthening, ergonomics).
HISTORY
It was in the 1980s that Dr. Janet Travell and Professor David Simons from the USA focused their scientific work on the musculature:
the musculature can directly cause both acute and chronic states of pain. Travell and Simons introduced the concept of "myofacial trigger points" which, as dominant disease factors, are very often responsible for pain and functional restrictions.
In the 1980s, Dr. Beat Dejung from Winterthur/Switzerland completed the concept of trigger point therapy by treating not only the trigger points but also the connective tissue with manual techniques (Swiss approach).
Indications for trigger point therapy
back pain (with/without radiation in the legs), headache and pain in the neck, pain in the shoulder and arm, epicondylitis, pain in the lower limbs, motor restrictions, muscle weakness and lack of strength, disorders of coordination can be directly triggered by trigger points.