It’s common for many people to experience pain that is caused by “muscle knots.” These painful knots are commonly referred to as trigger points or myofascial pain.
What Are Trigger Points?
A trigger point is a knot or small bump within the tight band of the connective tissue that covers your muscles. When you touch it, it feels like a hardened lump. When pressed, it is often painful.
In many cases, muscle knots cause pain to radiate beyond the trigger point into surrounding muscles. During certain body movements, it may also cause pain to be referred to other areas of the body.
What Is “Referred Pain”?
Referred pain is when you feel pain in one part of your body, but the real source of the pain is located somewhere else.
For example, herniated discs or spinal stenosis can cause pain that radiates into the legs or hips. Or the compression of the sciatic nerve produces pain from the buttocks down the leg.
What Are the Possible Causes of Trigger Points?
There isn’t a broad medical consensus on what causes trigger points. It may start after a strain or injury to muscles, ligaments, or tendons. Performing movements or exercises with poor form or incorrect posture may be a cause. Mental stress-related muscle tension may also be a factor.
They can also result from muscle overuse or repetitive motions. Additional causes include limited physical activity, extended bed rest, pinched nerves, vitamin deficiencies, hormonal imbalances, dehydration, or exposure to cold environments.
In a nutshell, the causes of muscle knots can vary significantly from person to person.
How Does a Healthcare Provider Diagnose Trigger Points or Myofascial Pain?
Trigger points can often be misdiagnosed because they don’t cause visible signs like redness or swelling. They also can’t be detected through lab tests, imaging, or electromyography.
The most effective way to diagnose trigger points is with a physical muscle exam. A healthcare provider specialist will press on your muscles to identify painful sports or myofascial trigger points. They may also recommend imaging or lab tests to rule out other causes of muscle pain, such as injuries or unrelated medical conditions.
How Are Trigger Points Treated?
Treatments for trigger points or muscle knots will vary based on symptom severity.
A healthcare provider may recommend medications such as pain relievers, muscle relaxers, steroids, or anti-inflammatory drugs. They may also prescribe strengthening and stretching exercises with a physical therapist, along with dietary changes to reduce inflammation.
The most effective treatments focus on directly addressing the trigger points, which may involve injections to reduce inflammation.
What Are Trigger Point Injections?
A trigger point injection can help soothe myofascial pain, or pain from muscle knots, especially in your neck, shoulder, arms, legs, and lower back. Trigger point injections commonly involve injections of local anesthetic with or without a corticosteroid.
A trigger point injection may be appropriate if myofascial pain has not improved with other treatments. However, healthcare providers typically use trigger point injections alongside physical therapy and stretching exercises to alleviate the pain.
They are also beneficial for individuals who are unable to do physical therapy or stretching due to intense pain. The trigger point injection can allow physical therapy to be more effective.
How Common Are Trigger Points and Myofascial Pain?
Chances are that you’ll experience the tender, achy feeling of a trigger point or muscle knot at one point in your life. In fact, they occur in about 85% of the population.
You should see a doctor for myofascial pain if it persists for more than a few weeks, does not improve with rest and self-care, or if it interferes with daily activities and sleep. Seek medical advice if you notice persistent, tender muscle knots, reduced range of motion, or if pain radiates.