Chiropractic CE

Chiropractic for Trigger Point Pain

            Trigger point pain is a fairly common issue we see quite often being chiropractic providers, most commonly being in the neck, shoulder, and upper back regions. Being that most people will have myofascial pain at some point in their life, and although they often only last a few weeks, there are many who continually experience pain from them regularly. Fortunately, chiropractic offers relief and better quality of life without medication. Trigger point therapy offers our patients the option to truly help the pain as opposed to mask it.


Trigger Point Basics


            Although trigger points can be found in various parts of the body, the most common areas that are afflicted with trigger points tend to be the neck, upper back, and shoulders. Trigger points are sensitive, tight knots located in one or more the muscular regions taut bands. As providers, it is most important to know that trigger points can vary between people, and they are not necessarily in the same spots in every person. Pain is not the only symptom to occur when a patient has these nodules. Other symptoms include burning, tingling, and weakness.


Trigger points are usually caused by various kinds of trauma or overuse including:


  • Taking an unexpected weight
  • Repetitive strain from postural issues, typing, or weakened spine
  • Prolonged tension/overuse of a certain muscle due to something like a sport
  • Another pathology causing pain to a muscle
  • Clenching muscles when stressed
  • Prolonged inactivity


Even though there can be varying causes as to the formation of trigger points, according to the National Association of Myofascial Trigger Point Therapists, injury and stress are the two major culprits leading to trigger point generation. Trigger points can also exist within a muscle for several years without symptoms except for stiffness which is known as latent trigger point. When pain makes itself present, this is known as activated trigger point most commonly caused by emotional stress, physical cold, or fresh trauma to the affected muscle.


Chiropractic Trigger Point Therapy

There are a multitude of benefits to chiropractic treatment for trigger point pain. Chiropractic providers know more than most the benefits that chiropractic treatment on trigger points, but it is important to explicitly know the benefits and be able to explain them clearly to our patients.


Benefits of chiropractic for trigger point pain include:
  • Smooth out the trigger point with hands and tools
  • Break up adhesions which cause the muscles to get caught instead of sliding smoothly. These adhesions are painful, and causes the joints to misalign.
  • Enhance overall alignment through chiropractic. Inaccurate movement puts strain on the patient’s muscles, and since chiropractic helps the whole body becomes aligned which can prevent future issues and ease muscle pain.


Above all, the main benefit of chiropractic for trigger point pain is after treatment there is an ease of movement and an increased range of motion.


Chiropractic Protocol for Trigger Point Treatment


         The main goal of a chiropractic provider with trigger point therapy, whether with their hands or with tools, is to create inflammation in the trigger point in order for the body to re-heal itself with improved tissue. It should be known that depending on the severity of the patient’s issues, it is important to always be honest and advise them to seek complimentary treatments along with their chiropractic trigger point therapy. Manipulating trigger points with moderate pressure in addition to stretching, we can increase mobility and reduce pain. It is important not to put too much pressure on the trigger point as this could cause the muscle to tense up. To find trigger points, press on the muscle tissue and manipulate the muscle fibers.
We should always advise the patient that the release of pain is gradual not instantaneous, and be sure to gauge the patient’s discomfort on a 1 to 10 scale. Keep applying pressure to the patient until the patient states they are at a 5 or 6 on this scale, and continue to apply gradual pressure until the pain goes down to a 2 or lower on the scale. At this point, the trigger point is considered to be deactivated. Again, the patient should know that this is not a quick fix, and the same way as it took time to develop, it will take time to deactivate. Trigger point therapy is uncomfortable; however, it should not be painful. Using manipulation that is too harsh can cause the muscles to reverse any positive effects from the therapy. If the pain still persists, then the problem may be something other than a trigger point.
Additionally, as chiropractic providers we need to be aware that there are a variety of conditions which patients are misdiagnosed with due to trigger points.
Some of these conditions include:
  • Earaches
  • Fibromyalgia
  • Appendicitis
  • Jaw pain
  • Sciatica
  • Carpal Tunnel
  • Sinusitis


Since chiropractic providers look more at the musculoskeletal system than a primary care provider, which is usually why we can determine that some issues that a patient has are actually due to trigger points. Guide the patient on improvements in gentle exercise, regulating their diet, proper posture, and a regular sleep schedule, in addition to stretches they can complete on their own at home.


Chiropractic & Trigger Points


            About 10 percent of the population or 23 million people in the United States have one or more chronic musculoskeletal system disorders. There is still so much that the medical world is learning about the human body every day, and in the world of chiropractic we are able to dig deeper and take a closer look at the musculoskeletal system helping patients really zero in on the issues. Trigger points are easy for patients and providers to push aside or shove pain medication at, but we can truly make a difference that will help our patients long-term with chiropractic care.