Osteopathic treatment of trigger points

Trigger points are very tender areas within a muscle which are grouped into two types – active and latent. Active trigger points refer pain and tenderness to other areas of the body on the application of pressure. Some of these referrals can be quite distant from the trigger point site, for example, trigger points in gluteus minimus can refer pain all the way down the side of the leg to the outside of the ankle or down the hamstrings and into the calf mimicking sciatic nerve pain. Latent trigger points only present pain at the point of pressure, not elsewhere and are often linked with stiffness and joint restriction particularly in old age. They can be caused by a range of things including poor posture, trauma at birth, injury or trauma or overexertion.

Trigger points are not the same as acupressure points as they can be felt by touch. They are often associated with ‘knotted’ muscles’ and conditions that are less common such as myofascial pain syndromes or fibromyalgia where they can cause debilitating symptoms resulting in time off work and disability.

Osteopaths and many other manual therapists often treat using trigger point therapy (also known as myofascial trigger point therapy) and massage combined. They apply pressure at different levels to these tender muscular areas in order to relieve pain and other symptoms locally or in the referred areas. By being treated in this way, muscles are re-educated into pain free habits, the stiffness and swelling resulting from neuromuscular pain reduces, range of motion is restored and circulation, coordination and flexibility are improved. It is especially important to remember that the diagnosis and treatment of trigger points may be the answer in protracted cases where patients are not getting relief from traditional treatment whether that be by manual therapists or the medical profession.

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