Trigger point therapy guide

Important background information

In this section we will go over the background information, or if you are just after the treatment skip ahead to the solution.

1. what trigger points are,
2. why courses of therapies such as needles, laser and manual therapies only temporarily relieve pain, and
3. how we can use our knowledge of trigger points to do better.

What trigger points are

Why courses of therapies such as needles, laser and manual therapies only temporarily relieve pain

“De-activation” the scientific illusion

Every scientist who conducts clinical trials does extensive background research studying what has been done before. Therefore, all those conducting trials of trigger point therapies would have studied the proof shown here, that typical courses of trigger point therapy do not eliminate trigger points. Rather than have this inconvenient fact spoil their results they do do the following when they conduct their trials on therapies such as needles or laser:

• make the goal of the treatment “de-activation” rather than elimination (12)⁠, and
• deliberately choose not to check whether the trigger points are still there afterwards, and instead measure thinks like pain and other symptoms.

By doing this the scientists are able to write their trials up as a success. For our research we found over 30 such trials (see summary below). Each claimed that their treatments successfully treated trigger points, where the reality is that all any of them ever proved that was that their expensive courses of therapy give temporary symptom relief. Hoping people do not understand what “de-activation” means these trials are used as follows.

1. Sellers of lasers, needles and so forth market their therapies as “proven” to professionals.
2. Professionals have you believe that their courses of treatment “fix” the problem.

How we can use our knowledge of trigger points to do better

For reasons discussed above most of the clinical trials of trigger point therapy are of little use and arguably deliberately misleading, so to put together the effective solution below we looked at at the following information we do have.

• What trigger points are and how treatments help
• Evidence where trigger points have actually been eliminated
• What causes trigger points.

We need to address parts of the feedback loop

This feedback loop can be slowed or stopped by addressing any part or parts of the loop. Each therapy may affect a different part (16–19)⁠. This is why there are so many therapies. For example, massage helps relax the muscle, increase blood flow and squeeze out waste products. In our solution section we use a treatment that will address every part.

We need to eliminate trigger points properly

We need to eliminate the trigger points properly, because as long as the trigger point is there the positive feedback loop will continue and the lump will continue to grow.

Evidence that trigger points can be eliminated

While the 12 week trial discussed above showed that typical courses of therapy will not eliminate trigger points they did manage to diminish the trigger points and eliminate some. This tells us that treatments will reduce trigger points and eliminate them over time. The main issue is that the therapy must be continued for long after the pain has gone. If using professional services for all this will be totally impractical and not affordable for most. Because of this our solution section gives therapies you can easily do yourself at home.

The cause of trigger points

If we can reduce or eliminate things that cause trigger points this will help stop them developing or re-forming. In the solution section we look at things you can do.

The solution

The basis of our solution is very simple

1. We show you an effective therapy that you can easily do at home. That way you can continue to treat the trigger points long after the pain goes, continuing to reduce them and hopefully eliminate them altogether.
2. Show you how to reduce or eliminate the things that cause trigger points to develop.
3. Have you do some regular but less frequent maintenance once health has been restored

The effective therapy you can easily do at home

Other home techniques

If you do not have the appropriate equipment there are a variety of self massage techniques where you can use either you hand or a simple tool. For details please see this article or the video above.

How many treatments do you need?

As discussed above 12 weeks of very effective therapy managed to eliminate 1/3 of the trigger points, while reducing the others. To properly eliminate trigger points using your home therapy may require 50-100 treatments, but if you can do them at home and it doesn’t cost what does it matter? As long as you are continually improving you can be happy. Simply, what you do is continue the treatments until the pain has gone, then keep going until you can no longer find the trigger points when you examine for them. One you are trigger point free it is good to keep going with some regular but less frequent maintenance.

How to reduce or eliminate the things that cause trigger points

Avoid postures or activities that tighten your muscles

The classic example is sitting at a desk, however, there are may other activities that could cause issues. Our government worksafe has this excellent practical reference that covers most situations, including how to set up your chair and desk.

Regular breaks

If you are in a situation such as sitting at a desk where your muscles may tighten take regular breaks, doing some light stretches or exercises.

Muscular maintenance

Regular massages or the regular use of any of the the techniques we have shown you will help maintain your circulation.

Psychological and emotional stresses

Is these issues are causing you to tighten your muscles a lot seek some professional help on how to deal with them.

Do some regular but less frequent maintenance once health has been restored

Once you are free of trigger point congratulations. Now you and do things like get regular exercise, avoid things that can cause trigger points, and have regular “maintenance” or “check up” therapy to keep your muscle healthy.

BONUS: how to do trigger point therapy for various parts of your body

On our website we have a host of guides with specific advice for trigger points in various conditions and various parts of your body. These usually have:

• specific muscles and points, and
• specific techniques for those.

Here a some examples.
Self massage and trigger point therapy for headaches and migraines
Massage and trigger point therapy for low back pains with self help options
Massage and trigger point therapy for calf pain, with self help options
Massage and trigger point therapy for shoulder pain with self help options
Self massage and trigger point therapy for tennis elbow
Does massage help with fibromyalgia, with self help advice

Appendix: What the research says about individual trigger point therapies

Below is a summary of the findings of several scientific reviews of trigger point therapies (12,20–27)⁠. As discussed above these trials deemed "success" to be just a temporary reduction in symptoms, and as you can see they can take a lot of sessions to even achieve that.

Laser

Trial results for laser have been marginally better than those for dry needling, but still only temporary relief. Scientists attribute it’s effect to increasing micro-circulation, improving oxygenation and helping remove waste products. However, this is something that can easily be achieved, if not better, by any competent massage therapist.

The big concern with laser is the sheer number of applications of therapy needed for only temporary benefits. For example one trial (28)⁠ used 10 daily applications of laser on patients with upper back and neck pain to get a reduction in pain and tenderness for three weeks. Further, according to one review (29)⁠ applications of laser should be given from 2-3 times a week though to 5 times a week, with a total of 30 applications of therapy for long term cases. Keep in mind this is just to achieve deactivation, not to eliminate the problem. Assuming each laser consultation costs $50 and takes an hour out of your day that’s $1,500 and 30 hours of your life just for some temporary pain relief, leaving you to front up again next time the problem is aggravated.

Dry needling

Most trials show that dry needling provides some short term pain relief and improved function, and where dry needling had been compared with laser the laser has given slightly better results. Again, you are going to need a lot of needles for very little benefits.

Manual therapies

There are various types of manual therapies that involve pressure, massage and stretching of muscles. The trial results for them tend to be similar to those of laser and dry needling. However, according to one review (21)⁠ one study did show residual benefit after six months.

References

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21. Denneny, Diarmuid et al. Trigger point manual therapy for the treatment of chronic noncancer pain in adults: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2019;100(3):562–77.
22. Tough EA, White AR, Cummings TM, Richards SH, Campbell JL. Acupuncture and dry needling in the management of myofascial trigger point pain: A systematic review and meta-analysis of randomised controlled trials. Eur J Pain. 2009;13(1):3–10.
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26. Pavón, María J. Guzmán et al. Comparative effectiveness of manual therapy interventions on pain and pressure pain threshold in patients with myofascial trigger points- A network meta-analysis. Clin J Pain. 2022;38(12):749–60.
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