By some estimates up to one third of the adult population suffers from some form of chronic pain. Chronic musculoskeletal pain is the number one cause of disability in people under 45 years of age in North America. It is the number two cause for visits to primary care physicians and for work-related absences. It is responsible for 80 billion dollars a year in lost productivity. 

One type of musculoskeletal pain is called Myofascial Pain.  It is estimated that Myofascial Pain may be responsible for up to 85% of all chronic pain.  Myofascial Pain is diagnosed by the presence of trigger points. Trigger points are knots in the muscles caused by contracted muscle fibers.  These trigger points cannot be seen on any imaging tests like X-Rays, CAT scans or MRIs.  Trigger points are identified by palpation (feeling for them). It requires a trained and skilled practitioner to find trigger points.

One of the key features of Myofascial Pain and Trigger Points is that the pain is often felt at a site distant from the source of the pain.  This is called referred pain.  The trigger point itself (source of the pain) is very tender to touch but often the aching pain and symptoms (site of the pain) are felt somewhere else.  Every muscle in the body has a unique referral pattern.  This referred pain can cause confusion for doctors and therapist who are not familiar with the referral patterns.  Frequently patients are misdiagnosed and given ineffective treatment.

Trigger points usually cause a deep aching pain in the muscles, but they can also cause other symptoms such as headaches, tooth ache, ear pain, fullness and ringing in the ears, dizziness, nausea, heartburn, angina, watery eyes, runny nose, blurry vision, numbness or tingling in the hands and feet, pain in the joints.

There are many ways trigger points can be activated. Trigger points form when a muscle is injured by a fall, an impact, whiplash or overworked by lifting, sports or repetitive use. Sometimes trigger points occur in people who have not had an injury that they can remember. Trigger points can also be caused by poor posture, poor work ergonomics or even fallen arches in the feet.  Myofascial therapists are trained to identify these factors and help the patient correct them to achieve lasting relief from pain.

Myofascial pain and trigger points should be considered in every patient that has a diagnosis of:

  • Back pain
  • Headaches
  • Neck pain
  • Rotator cuff (shoulder) pain
  • Jaw pain (TMJD)
  • Tennis elbow
  • Carpal tunnel syndrome
  • Hand and arm pain
  • Repetitive Strain Injuries
  • Pelvic pain
  • Hip pain
  • "Sciatic" pain (buttock pain)
  • Leg and knee pain
  • Plantar fascitis (foot) pain
  • Tendinitis/tendinopathy
  • Burstitis
  • Arthritis
  • Disc pain (bulge/rupture/herniation) and radiculopathy
  • Frozen shoulder
  • Fibromyalgia