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Trigger Points and Pain

Trigger points are persistent, localized muscle spasms that can cause a great deal of pain. Trigger points alone may be responsible for many cases of neck pain, upper back pain, and lower back pain. This relationship is fairly common knowledge among physicians who treat pain, including chiropractors, rheumatologists, and physiatrists (doctors of physical medicine).
What is not generally known is that trigger points may also be implicated in radiating pain into the arm and hand or radiating pain into the leg and foot. In fact, radiating pain due to trigger points may be mistaken for pain caused by a herniated disc, in either the neck or lower back. Trigger point pain affecting the wrist and hand may even be misdiagnosed as carpal tunnel syndrome. A patient in whom a correct diagnosis of trigger point pain is missed may lose much precious time and other resources, as she fruitlessly "tries" one doctor after another and needlessly undergoes all sorts of complex and costly testing.
The key to correctly identifying the source and cause of upper or lower extremity radiating pain is to be able to accurately characterize its nature. Radiating pain caused by trigger points is diffuse - the pain broadly covers a region. This diffuse pain is described as "scleratogenous", meaning that it is pain referred from connective tissue such as muscle and tendon. Radiating pain caused by a compressed spinal nerve (ultimately caused by a herniated disc, for example) is described as "radicular" or "dermatomal". This pain is confined to a specific area - the area that is 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.
Scleratogenous pain is not specific. A person might complain of pain across the "shawl" portion of the upper back and traveling into the upper arm, experienced "all over" the upper arm. Another person might be experiencing pain across the gluteal region, hip, and upper thigh. Both of these patterns of radiating pain are likely due to several trigger points, localized to the respective areas.
Of course, an accurate diagnosis is necessary to be able to develop an effective treatment strategy. The good news is that although trigger points necessarily represent a chronic muscular process, they may be treated with very good to excellent outcomes using conservative protocols. Chiropractic care is the optimal 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 radiating pain. Chiropractic care improves mobility and restores function, helping to reduce and 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

Multicare Health Clinic

3930 STADIUM DR
SIOUX CITY, IA 51106
Phone Number: (712) 276-4325

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Monday:

8:30 am-6:30 pm

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8:30 am-6:30 pm

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8:30 am-2:00 pm

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  • "After an accident at work I didn't think I'd ever get relief from my aching shoulder. But, the doctors at Multicare gave me adjustments and physical therapy and now I feel normal again."
    Cliff C.
  • "I now can go a full week without pain and headaches."
    Luke W.
  • "I leave here feeling confident that I have the resources to manage my pain and live normally, and that's priceless."
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  • "Dr. Sneller helped. I haven't been feeling dizzy anymore."
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  • "After my knee surgery I was asked where I wanted to do my physical therapy, I chose Multicare Health Clinic and I'm so glad I did! Dr. Steve and the therapy assistants (Sara and Megan) are fabulous! They know what they're doing and they all really seemed to care about my recovery. I'm feeling fantastic! I'll definitely go back again whenever I need therapy or adjustments."
    Sheri J.
  • "Not only is my pain level down to zero, but what I'm really thrilled with, is that I have normal feeling in my hands."
    Jill L.
  • "I'm now a believer now! I didn't think chiropractic could help my foot problems. But after meeting with Dr. Pistello and Dr. Dave for a few weeks, I'm feeling so much better!"
    Gino G.
  • "My shoulder and neck feel so much better. I now have the knowledge, motivation, desire and tools to keep up the exercises."
    Barb B.
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    Jim J.
  • "Being able to present my back pain to three different professions in one place and knowing that they are working together to make me better is very comforting."
    Charlie P.
  • "After my consultatin with the doctors at Multicare Health Clinic, I understand how to address my balance issues."
    Anna A.
  • "I wasn't able to use my hand the way I should. After working with Dr. Sneller and the physical therapy team, I can use my hand again."
    Henry H.
  • "I'm so glad my sister referred me to Multicare! My elbow hasn't felt this good in a long time. Thanks to the great physical therapy team there."
    Ellen E.
  • "At night my right hand would go painfully numb at least 2-3 times where I could not sleep. Now, I don't have that pain and can get a full night sleep."
    Janet D.
  • "I wasn't able to use my hand the way I should. After working with Dr. Sneller and the physical therapy team, I can use my hand again."
    Ivy I.
  • "I'm a runner. When I wasn't able to run due to leg problems, I was devastated. But a consultation at Multicare Health Clinic identified the problem and after some adjustments, stimulation treatments and therapy, I'm running again!"
    Lisa L.
  • "There couldn't be a better physical therapy team in Siouxland! Not only did my knee feel so much better after six weeks, but I feel like I made new friends."
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