Trigger Point Pain: Commonly Overlooked and Misunderstood


Trigger Point Pain often mimics symptoms of other diseases, or sources of pain such as internal organs, so it is often overlooked as originating in the musculoskeletal system. It is common for trigger point pain to go unexplained even after extensive tests are completed, because the only way to diagnose trigger points is by physical examination and there aren't many physicians trained in the medical concept.

"Part of the problem is the common position that, if an organic cause [physical change in the structure of an organ or part] can not be demonstrated by a laboratory test or an imaging technique, there can be no organic cause for the pain. The frequently overlooked conditions that are discussed below [myofascial trigger points, articular dysfunctions, intervertebral discs surface damage, enthesopathy at the junction of the disc and the vertebral endplate and multiple interacting conditions] have some common characteristics: they cannot be diagnosed by a currently available laboratory test or imaging technique, they are not apparent on the usual routine medical examination, and they require special skill and training in what to look for and how to examine for diagnostic findings." Myofascial Pain and Dysfunction: The Trigger Point Manual Vol. 1, 2nd ed. 1999, page 804

"The lack of general agreement as to appropriate diagnostic criteria for examining trigger points has been an increasingly serious impediment to more widespread recognition of myofascial trigger points and to compatible studies of the effectiveness of treatment."Myofascial Pain and Dysfunction: The Trigger Point Manual Vol. 1, 2nd ed. 1999, page 31

Mimicked symptoms of Cardiac pain, tachycardia, radiculopathy, headache disorders, Meniere's Disease, occipital neuralgia, ringing in the ears, vertigo, atypical facial neuralgia, tic douloureux, cogenital as well as spasmodic torticollis, loss of hearing, projectile vomiting, among others have been documented as being caused by trigger points. This does not mean all of these conditions are caused by trigger points, all of the time; it does mean trigger points convincingly mimic the symptoms of these conditions and diseases, and potentially explain why treatment of a condition fails or gets only partial relief.

"The Severity of Symptoms range from agonizing and incapacitating [active trigger points] to painless restriction of movement and distortion of posture due to inactive trigger points," according to Janet Travell, MD, and David Simons, MD. in Myofascial Pain and Dysfunction: The Trigger Point Manual Vol. 1, 2nd ed. 1999, page 13. When you rub yourself and find a painful place you weren't aware of until you touched it, that is probably an inactive, or latent trigger point; the mime mentioned in the headline above.

Muscle and connective tissue have been documented and mapped by researchers since 1843 as the origin of problems, though lack of agreement about the diagnostic criteria limits the use and access to this wealth of information.

"Voluntary (skeletal) muscle is the largest single organ of the human body and accounts for nearly 50% of body weight, and fascia (connective tissue) is the most pervasive tissue in the body. Yet the muscles in general and trigger points in particular receive little attention as a major source of pain and dysfunction in modern medical school teaching and in medical textbooks." - Myofascial Pain and Dysfunction: The Trigger Point Manual Vol. 1, 2nd ed. 1999, page 13

Pain Mapping begins the process of finding the muscles most likely causing the trigger point pain and organizes therapy; however, it does not rule out internal organ problems or other disease. It's important to keep your physician informed and involved.

Trigger point pain is not funny, even though it mimics other diseases, may be silent like a mime and acts like a ventriloquist of the nervous system because the pain and dysfunction it causes shows up at a distance from the problematic trigger point nodule.

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