Trigger Point Therapy: A Path to Pain Relief and Muscle Recovery
The UK healthcare system currently lacks effective treatment options for musculoskeletal clinical conditions and pain, leading many to seek specialised private care. One of the most effective methods out there is Trigger Point Therapy.
Key professionals that are growing in popularity who work with musculoskeletal conditions in the UK include:
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Clinical Massage Therapists: Specialists who combine various techniques including myofascial release and trigger point therapy within the same treatment session in order to obtain the most effective results possible, offering treatments that typically last an hour.
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Myofascial Release Therapists: Specialists in the treatment of the myofascial system, that has grown in popularity over the last few years and is becoming the got-to treatment method for athletes and many people when in need for pain relief. Their work is based on a whole body based approach. Treatments last for usually an hour and are deeply healing.
While these specialised manual therapists often work in private practice, there is growing recognition of their effectiveness in treating musculoskeletal conditions.
Some specialised treatments like myofascial release are starting to being offered in select NHS facilities, particularly in Multiple Sclerosis and cancer therapy centers, though access remains very limited.
The unregulated nature of some of these professions presents both challenges and opportunities – allowing for quick adaptation to new scientific findings but making it difficult for patients to identify highly trained practitioners from those with basic training.
What is Trigger Point therapy
As we mentioned above, Trigger Point therapy is a popular skill used by specialised hands-on therapists.
Trigger Point therapy is a very effective tool to relieving musculoskeletal pain and tension as well as to increasing range of motion and tissue functionality and to enhance athletic performance and recovery.
Trigger Point therapy obtains great results by releasing Trigger Points within the myofascial tissue.
Trigger Points are localised hyper irritable spots within a taut band of muscle fibres that cause pain and other symptoms. They’re often hard to touch so they’re commonly referred to as “knots”.
Trigger Points can be active – causing active pain and symptoms – or latent – not actively causing pain but still negatively affecting muscle function and range of motion as well as imbalances within the myofascial system, they usually become painful when touched –
Trigger Points can cause pain locally to their location or radiate pain to other areas of the body, known as “referred pain”.
Understanding the nature and location of trigger points is the main role of the Trigger Point or Clinical massage therapists and is crucial for effective treatment and pain management. We’ll look into this topic more in detail below.
Trigger Points can develop due to various factors including overuse, trauma or injury, poor posture, chronic stress, compensatory patterns, poor diet/hydration and other health related habits.
How does Trigger Point Therapy work?
Trigger Points have predictable pain patterns.
What does that mean?
Let’s travel back in history a bit…
in 1942, Dr. Janet Travell an incredible physician, began her groundbreaking work documenting trigger points and their referred pain patterns. As she treated patients she realised that these Trigger Point pain patterns were consistent across different people, leading her to document these detailed “maps” of trigger points and their associated pain patterns.
These maps became an invaluable resource for therapists, allowing them to trace symptoms back to their source trigger points and provide effective treatment. Her work was captured in a two-volume textbook and it has become a fundamental tool for modern clinical massage therapy and myofascial release work.
The specialist therapist job is to identify the origin Trigger Point causing the pain and symptoms. They do this based on the client’s description of symptoms and area of pain, postural assessment and orthopaedic assessment, their psychosocioeconomic background, their lifestyle etc.
The therapist carries out a thorough consultation in order to:
- discard any non-related musculoskeletal conditions that might be causing the symptoms
- locate the origin trigger point
- identify compensatory patterns that might be contributing to the problem
Once the Trigger Point is located the therapist will proceed with treatment.
At INSIDE we use a gentle progressive approach to treatment based in a whole-body understanding of our musculoskeletal system. This means that we often start preparing the body and the area and/or treating other areas before we get into more focused Trigger Point work.
Trigger Points can be released in 2 main ways:
- Dry needling. Dr Janet Travell’s go-to technique. Trigger Points are released using a very fine needle.
- Manually through sustained pressure over a period of time. This is our method of choice at our clinic.
For Trigger Points released manually, the therapist will apply gentle firm pressure to the Trigger Point and hold it for a certain amount of time, usually enough for 8-12 seconds but often held for longer.
How though? How does the Trigger Point dissolve?
The science behind trigger point release
The science behind trigger point release through sustained pressure is constantly evolving and changing. Here are some response mechanisms through which Trigger Point release is effective in releasing musculoskeletal pain:
1. Circulatory Response
When sustained pressure is applied to a trigger point, it temporarily restricts blood flow to the area. When the pressure is released, there’s a surge of fresh blood flow – known as reactive hyperemia. This surge of blood brings oxygen and nutrients as well as helping clear waste elements that had been stuck in the area.
2. Neurological Response
Pressure on trigger points stimulates mechanoreceptors in the tissue, which can help reset muscle tension through various neurological pathways.
3. Pain Gate Control
The sustained pressure activates larger nerve fibres that help to “close the gate” to pain signals, following Melzack and Wall’s Gate Control Theory of Pain. This helps explain the immediate pain relief often experienced during and after trigger point therapy.
4. Fascial Release
The pressure applied during trigger point therapy also affects the myofascial tissue. Under sustained pressure, the fascia undergoes a process called piezoelectric effect, which helps to:
- Stimulate cellular repair and tissue remodelling
- Influence local cellular behaviour and metabolism
- Help restore normal tissue elasticity and function
The combination of these mechanisms explains why sustained pressure is more effective than quick, aggressive pressure in treating trigger points.
At INSIDE we use Trigger Point Therapy as part of a mixture of specialised hands-on techniques in order to increase the effectiveness of the treatment.
During a Clinical massage session, you can expect:
- A consultation including postural assessment, evaluation of goals, pain patterns, range of motion testing, medical history review, and lifestyle factors
- 1 hour long session
- A combination of specialised techniques including trigger point work
- Goal-oriented treatment with measurable outcomes
- A deeply relaxing and healing experience that works with your body, not against it
After your session:
- In some cases immediate pain relief and increased range of motion, in some other cases follow up treatment is necessary. For chronic conditions, multiple weekly sessions may be needed, with most people experiencing full relief of symptoms within 3-4 sessions. Results are expected within 6 weekly sessions even for complex cases.
- A 2-3 day settling period where tissue may feel irritated
- Improved overall feeling of wellbeing and mood
Recommendations for treatment day:
- Avoid alcohol
- Drink plenty of water
- Maintain a healthy, clean diet
- Avoid exercise to allow restoration
References:
Melzack, R., & Wall, P. D. (1965). Pain mechanisms: A new theory. Science, 150(3699), 971-979. DOI: 10.1126/science.150.3699.971
Langevin, H. M., et al. (2013). “Dynamic fibroblast cytoskeletal response to subcutaneous tissue stretch ex vivo and in vivo.” American Journal of Physiology-Cell Physiology, 305(12), C1146-C1158. DOI: 10.1152/ajpcell.00504.2012
Fairweather, R. and Mari, M.S. (2015). Massage fusion : the Jing method for the treatment of chronic pain. Edinburgh: Handspring Publishing.
About the author
Rocio Santiago
MA in Nursing, Dip. Soft Tissue Therapy
Ro initially began her career as a nurse. Following this and after a difficult time in her life that resulted in a career change, Ro went on to train at one of the leading soft tissue therapy schools in Europe, completing a 3 year degree level course and specialising in effective soft tissue manipulation for the treatment of musculoskeletal pain.
The treatment method Ro uses consists of a combined approach using different specialised techniques, myofascial release and trigger point work among others, with the intention and focus on providing effective results in the least possible amount of time.
Combining her training, science background and life experience, her treatment method is based in science and built using a whole body approach, where mind and body are addressed as one.
Ro has been seeing clients as a soft tissue therapist for 8 years, successfully treating a wide range of conditions.