Trigger Points

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Original Editors -Sean Wauters

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Search Strategy

Keywords : Trigger points AND therapy AND/OR injection AND/OR exercise

Consulted databases : Pubmed, Pedro, Web of Knowledge

Definition/Description

Trigger points are swollen and hyperirritable spots located in a taut band of skeletal muscle. It is a small part of the muscle that contracts and not the entire muscle. They produce local pain and can often accompany chronic musculoskeletal disorders.

Clinically Relevant Anatomy

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Epidemiology /Etiology

Trigger points may be at different places in both skeletal muscles in the hip, neck, shoulder, ... they are usually in places where nerves connected the muscle fibers.
These are mainly due to overload, an injury sustained by a fall, by stress or birth trauma. Also a lack of exercise or a bad posture can lead to trigger points.  Trigger points have proven bone or myofascial pain Causes That are Responsible for neck and back pain.

Characteristics/Clinical Presentation

Trigger points are painful on compression or elongation of tissues and can also cause referred pain in a specific dermatomal and myotomal pattern. This could be possible by clamping the nerves or blood vessels bulge. The higher and continuing tension in the muscle can also be experienced stiffness and movement restrictions.

Differential Diagnosis

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Diagnostic Procedures

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Outcome Measures

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Examination

The study of trigger points can be recorded by palpation. The examintor will clearly able to sense a hardening and concern with the patient reported tenderness or pain during palpation.

Medical Management

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Physical Therapy Management

 There are several methods for the treatment of trigger points.

First the exact location of the trigger point should be palpated.
Trigger points may be relieved through noninvasive measures, such as spray and stretch, transcutaneous electrical stimulation, physical therapy, and massage.
Several studies have shown that ultrasound can help to treat trigger points, this treatment is very often followed by massage using transverse friction.  Massage can cause the soft tissue back and that the different sarcomeres in the muscle of each other loose.

Apart from these various methods can also be used invasive methods such as injections.

It is very important to inject the right place. For this, a study demonstrated that placing an injection using an ultrasound can help. Echo Conductive trigger point injections may help for proper placement of the needle into the muscle.

Key Research

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Resources

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Clinical Bottom Line

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Recent Related Research (from Pubmed)

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References

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