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Could Your Pain Be Caused By Trigger Points?

Chiropractic Care for Trigger Points

Trigger points associated with lower back and leg pain are commonly found the iliotibial band (located at the outer thigh), as well as in muscles in and around the hips and buttocks, including the psoas, gluteus maximus, and piriformis. Trigger points associated with upper back, neck, and arm pain are commonly found muscles near the upper back and neck such as the the shawl area which includes the trapezius muscle, the rhomboid muscles, and the levator scapulae.

These chronic, persistent, localized muscle spasms are caused by chronic poor posture, biomechanical faults, and stress. Any or all of these factors may be involved. Stress may be ongoing, depending on the person's circumstances, but posture and biomechanics can definitely be addressed and significantly improved with chiropractic care.

Your Millar Chiropractor will analyze and identify any biomechanical issues you may have - especially those involving spinal misalignments.  He or she will design a treatment plan specifically tailored for your individual needs and, if necessary, your chiropractor will help educate you regarding good postural habits and exercises that will be beneficial for many years to come.

Trigger points are persistent, localized muscle spasms that can cause a great deal of pain.1,2,3 Trigger points may be the singular cause of many cases of neck pain, upper back pain, and lower back pain. Many physicians who treat pain, such as chiropractors, rheumatologists, and physiatrists (doctors of physical medicine), are familiar with trigger points. However, they may not realize that trigger points can also radiate pain into the arm and hand or radiate pain into the leg and foot. Unfortunately, radiating pain due to trigger points can sometimes be mistaken for pain that is caused by a herniated disc, in either the neck or lower back. Similarly, trigger point pain that affects the wrist and hand may even be misdiagnosed as carpal tunnel syndrome. A patient for whom a correct diagnosis of trigger point pain is missed may waste precious time and money, as she fruitlessly "tries" one doctor after another while needlessly undergoing various complex and costly testing.

So how do we correctly identify the source and cause of upper or lower extremity radiating pain?  The key is to accurately characterize the nature of the pain.

Radiating pain caused by trigger points is diffuse - in other words, it broadly covers a region of the body. This diffuse pain is described as "scleratogenous", meaning that it is pain referred from connective tissue such as a muscle or tendon. Radiating pain that is caused by a compressed spinal nerve (usually caused by a herniated disc, for example) is described as "radicular" or "dermatomal". This pain is confined to a specific area - the area supplied by a specific spinal nerve. For example, pain involving the thumb and index finger could be caused by compression of the C6 spinal nerve. Pain involving the outside of the foot and the little toe could be caused by compression of the S1 spinal nerve.

The Scleratogenous pain of trigger points is not specific. A person might complain of pain across a large portion of the upper back and traveling into the upper arm, that is experienced "all over" the upper arm, not just in one small location. Another person might be experiencing pain across the gluteal region, hip, and upper thigh. Both of these patterns of radiating pain are very likely due to several trigger points, localized to the respective areas.
Of course, an accurate diagnosis is important to be able to treat the problem effectively. The good news is that although trigger points represent a chronic muscular problem, they are normally treated using conservative protocols, and with very good to excellent outcomes. Chiropractic care is the best method for managing trigger point pain. Chiropractic care is a drug-free approach which directly addresses the biomechanical causes of these persistent trigger points and their associated patterns of diffuse radiating pain. Chiropractic care improves mobility and restores function, helping to reduce and many times completely resolve chronic pain.
1Alonso-Blanco C, et al: Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity. Clin J Pain Feb 28 2011 (Epub ahead of print)
2Bron C, et al: Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial. BMC Med 9:8, 2011 (January 24th)
3Renan-Ordine R, et al: Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial. J Orthop Sports Phys Ther 41(2):43-50, 2011

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