What are muscle Trigger Points and how do we treat them?

What are trigger points? 

Myofascial pain syndrome is the term given to pain that is caused by one or more symptomatic trigger points in the skeletal muscle. Trigger points as they are commonly referred to, are localised areas of sensitive muscle tissue which can be palpated in the muscle fibres and are often painful on compression. Muscle trigger points can result in physical impairments such as loss of range of movement, weakness and painful muscle contractions.

Why do trigger points occur?

Trigger points often present in the same way, however they can have different underlying mechanisms. Trigger points can occur as a result of trauma or they can be non-traumatic. Non-traumatic trigger points can occur as a result of chronic low load, age or anatomy.

Chronic low load

As we age, humans tend to perform the same movements or postures out of habit. Those most susceptible to low load trigger points are students who sit in sustained postures for long periods, cleaners and computer operators. Sustained postures or small repetitive tasks use the same muscles over and over again leading to muscle fatigue and overload.


There is a higher prevalence of trigger points in those who are elderly. As we age muscles tend to become stiffer and less flexible which could make them more susceptible to trigger points. The elderly population are also more likely to be on medications which can have an effect on metabolism and the ways muscles utilise water and other nutrients again leading to higher susceptibility of trigger points.


There is often a common trend in which muscles present with trigger points and this can be attributed to the anatomy of these muscles. Muscles that are most susceptible are those with a design that twists on themselves such as those found around the shoulder and neck or muscles with a bony border. Muscles that we use on repetitive everyday tasks are also more at risk.

How do physiotherapists treat trigger points?

Physiotherapists will use a combination of treatment techniques for trigger point pain including soft tissue massage, deep tissue release and dry needling. Dry needling is one of the most common methods of treatment for muscle trigger points. It is called dry needling because the needles do not contain any liquid and go into the skin completely dry.

The needles differ in length depending on the depth required to target the muscle with the trigger point. Once the needle is inserted it is then moved around in the tissue in an attempt to elicit a localised twitch response. A twitch response is the rapid, involuntary contraction of the muscle fibre that contains the trigger point. Research evidence suggests that dry needling is an effective treatment for trigger points and is equally as effective as massage for trigger point release.

What can you do to help relieve trigger point pain?

When seeing a physiotherapist regarding trigger point pain we will advise you on self management in between physiotherapy sessions. Self management for trigger points involves all or some of the following: apply heat packs regularly to the affected area, perform self massage if possible using hands or a massage ball, regular stretching for the muscles involved and apply creams/rubs such as deep heat or Voltaren gel.


Nicola Carter



1. Boyles R. Fowler R. Ramsey D. Burrows E. Effectiveness of trigger point dry needling for multiple body regions: a systematic review. Journal of manual and manipulative therapy (2015) 23(5): 276-293.

2. AAP Education [Internet]. AAP Education; c2010-2017. Novel classification of trigger points (hypothesis); 2015 March 25 [cited 2017 July 28]. Available from: https://www.aapeducation.com.au/blog/entry/clinical-kit-25-3-2015-novel-classsification-of-trigger-points.html

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