Trigger Point Therapy
As you read this article, please note the author has used the initials T. P. off and on to mean Trigger Point. That is, T. P. = Trigger Point.
Trigger Point Therapy’s goal is to remove the nerve sources of muscular pain and physical dysfunction. It used to be called Neuromuscular Re-education or Therapy, but the medical/legal definitions of those words have changed to mean a modality only used by physical therapists with the client/patient in a standing position. We can however, call it a neuromuscular technique using Trigger Point Therapy.
We know we may be a candidate for Trigger Point work if we have constant, chronic discomfort and limited activity that is not relieved by other forms of massage, physical therapy, chiropractics, acupuncture, or cortisone injections. The only way to know is to make an appointment with a trained licensed massage therapist who uses touch, charts, and feedback from the client.
Identify the areas of pain
When the client first comes in, the therapist usually explains what Trigger Point Therapy is and that the first step is to identify the exact areas of pain and associated trigger points by looking at charts. The client shows where she/he is hurting by looking at the areas indicated by red, representing pain. The therapist observes the trigger points for those places, which are indicated by x’s on the charts. The x’s may or not be located in the red areas. The client is then asked if any particular movement or activity produced the discomfort, how long ago did it begin, and what does it feel like. Knowing if the dysfunction is constant, chronic, frequent or sometimes will help determine the length of therapy required for the technique to work.
The Sooner the Better
The closer to the event that sparked the pain, the more immediately effective trigger point work is. A personal story illustrates this: My daughter, in another city, called me one morning when her son was about 7 months old. She was crying, saying she hurt her hand the night before, now it was really hurting and she couldn’t open it. This was preventing her from holding, feeding or changing the baby. She wanted to know what she could do. I told her to first find someone to help with the baby then look for a massage clinic advertising Trigger Point Therapy or Neuromuscular. I told her to not go to any clinic or therapist who didn’t even know what these words mean. Advising her to book 4 ½ hour treatments, she got in there that afternoon and it only took the one treatment one time for her hand to open and all pain be gone. This was an unusual situation in that she was able to get the needed treatment before even 24 hours had passed.
The longer the pain pattern has been in place, the longer T. P. Therapy may take to work. If the pain is constant, chronic and severe, you may want to understand that it won’t go away with one treatment. The therapist should explain that Trigger Pont Therapy is slow, can be very painful, and only small areas of the boy can be addressed in one 60 minute session.
Establish your Priorities
The client needs to decide which area is her/his priority and what is most bothersome and limiting.
One really great thing about T. P. Therapy is that it works and clients may have complete confidence in the process. It may not go as quickly as desired and it may be more uncomfortable than thought, but it works. It does require teamwork between the therapist and client; and the client’s family and friends while making needed adjustments to one’s lifestyle to maintain the work.
Description of treatment
The client gets on the treatment table. Therapist goes to the chosen primary area to work and begins to warm the muscles both in the referred pain areas and the indicated t.p. locations to increase blood flow and remove any superficial tension. She/he then begins to make short passes over these areas with the thumb, looking for tight, taught bands of fiber that will indicate the presence of possible Trigger Points. When one is located, the client is asked to take a deep breath and as she/he exhales, the therapist applies deep pressure to the taut band. If this is a trigger point, the client will react in a distressed way as pain and all kinds on uncomfortable sensations arise both in the location of the t. p., the pathway from the point to the pain, and the painful areas. The trigger point is held until the client reports they just feel the pressure of the thumb or finger. This indicates release of the point and hopefully, the cessation of referred pain.
This is a demonstration of why this method of treatment is called neuromuscular. The therapist is rerouting the neuronal flow by a steady, strong, static pressure on the point. That strength is counterbalanced by the weakening of the pain response. Which can feel like burning, stabbing, cutting or extremely high levels of discomfort. The client requires reassurance that it won’t last as the pressure in maintained for a short to moderately short period of time. If the pain stops, we call this a Trigger Point Release. It absolutely shows the connection between muscles and nerves. As the therapist re-routes the neuronal flow along an established pathway to pain and dysfunction, the pathway changes directions and the pain stops and desists.
A back-up session is generally called for as the body has to relearn new ways of movement and muscular responses to the same. After every treatment, it takes about 48 hours to experience the full benefits. In those 48 hours, inflammation and pain may actually increase and then, day 3, no pain and feeling good.
As you’ve read, Trigger Point Therapy can be painful, time consuming and require back up treatments until the client’s desired results are achieved. The benefits are many, but the treatment is not a relaxing experience and almost always uses deep pressure. But you’ll feel better, sleep more soundly and be able to do the things you enjoy.
Find the Right Therapist
If you are looking for a massage therapist, even if you don’t need Trigger Point Therapy, never go to one that doesn’t know what Trigger Point Therapy or Neuromuscular Techniques are. That is a clear indication that they did not do the basic advanced massage training and may not know their anatomy and physiology.
To give some chiropractors, physical therapists and even orthopedic or neurological doctors credit, more of them are beginning to used Trigger Point Work in their practice. In these cases, I would make sure they had actually attended hands-on, live training as our experience has been they don’t always know how to locate the trigger points. This can be especially dangerous as M.D.’s can give injections directly into the trigger points. If they don’t know for sure where they are, it can be dangerous.
If you’ve been struggling with limited physical activity or enjoyment of life due to chronic pain issues, Trigger Point therapy may be the thing for you.
