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The trigger point model states that unexplained pain frequently radiates from these points of local tenderness to broader areas, sometimes distant from the trigger point itself. Practitioners claim to have identified reliable referred pain patterns which associate pain in one location with trigger points elsewhere.
Symptoms of a myofascial trigger point include: focal point tenderness, reproduction of pain upon trigger point palpation, hardening of the muscle upon trigger point palpation, pseudo-weakness of the involved muscle, referred pain, and limited range of motion following approximately 5 seconds of sustained trigger point pressure. [2]
Dry needling for the treatment of myofascial (muscular) trigger points is based on theories similar, but not exclusive, to traditional acupuncture; both acupuncture and dry needling target the trigger points, which is a direct and palpable source of patient pain. [1]
Ischemic compression is commonly applied to trigger points, in what is known as trigger point therapy, where enough sustained pressure is applied to a trigger point with a tolerable amount of pain, and as discomfort is reduced, additional pressure is gradually given.
A 2015 review concluded that the technique is ineffective for lower back pain, and the quality of research testing its effectiveness is poor. [12] Trigger point techniques claim to address myofascial trigger points, though the explanation of how this works is controversial. [9] [13] [14]
Myofascial Pain and Dysfunction: The Trigger Point Manual; Office Hours: Day and Night, The Autobiography of Janet Travell, M.D. Dr. Janet G. Travell, M.D.: "The Mother of MYOFASCIAL - TRIGGER POINT Knowledge" Travell, Janet G. (2003). "A Daughter's Recollection by Virginia P. Wilson". Texas Heart Institute Journal. 30 (1): 8– 12.
Referred pain, also called reflective pain, [1] is pain perceived at a location other than the site of the painful stimulus.An example is the case of angina pectoris brought on by a myocardial infarction (heart attack), where pain is often felt in the left side of neck, left shoulder, and back rather than in the thorax (chest), the site of the injury.
Bertolotti's syndrome is a commonly missed cause of back pain which occurs due to lumbosacral transitional vertebrae (LSTV). It is a congenital condition but is not usually symptomatic until one's later twenties or early thirties. [1] However, there are a few cases of Bertolotti's that become symptomatic at a much earlier age.