Why Do Trigger Points Hurt So Much? Here's the Answer

How Physiotherapy Treats Myofascial Trigger Points for Lasting Relief

Have you ever felt a tight, painful knot in your muscles that just won’t go away, no matter how much you stretch or massage it? These are known as trigger points, and they can cause persistent pain, stiffness, and even discomfort in areas far from where the knot is located.

Whether caused by injury, poor posture, or muscle overuse, trigger points can make daily activities uncomfortable and even limit movement. But what exactly are they, and how can physiotherapy help relieve the pain?

What Are Trigger Points?

Trigger points are hyperirritable areas of muscle that feel like tight knots or bands when pressed. These sensitive spots can cause:

• Aching pain in the affected muscle

• Pain that radiates to other areas of the body

• Reduced flexibility and movement

• Muscle weakness or fatigue

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Interestingly, trigger points do not follow nerve pathways. This means the pain is often felt in a different location from where the actual knot exists. For example, a trigger point in the neck may cause headaches, while one in the lower back may result in hip or leg pain.

Trigger points can develop due to macrotrauma (such as whiplash, a sports injury, or surgery) or microtrauma (such as prolonged poor posture or repetitive strain). If left untreated, they can cause ongoing discomfort and limit mobility.

Why Are Trigger Points So Painful?

Trigger points form when muscle fibres contract and fail to release properly, leading to restricted blood flow and a buildup of waste products in the tissue. This creates irritation and pain in the affected muscle.

Common causes of trigger points include:

• Muscle overuse or repetitive strain

• Poor posture and prolonged sitting

• Injuries such as whiplash or sprains

• Stress and muscle tension

• Nutritional deficiencies or dehydration

Because trigger points can disrupt normal muscle function, they may also contribute to headaches, dizziness, numbness, and even autonomic dysfunction in some individuals.

How Can Physiotherapy Help with Trigger Points?

Physiotherapy plays a crucial role in identifying, treating, and preventing trigger points. Unlike conventional stretching, which can sometimes worsen the pain, physiotherapy focuses on specific techniques to release muscle tension and restore mobility.

1. Direct Pressure and Myofascial Release

Physiotherapists apply sustained pressure to the trigger point, which helps: 

• Break down muscle tension

• Increase blood flow to the affected area

• Reduce pain and stiffness

  
  

This technique is often followed by gentle stretching to restore normal muscle length.

2. Dry Needling for Trigger Point Release

Dry needling is a technique where thin, sterile needles are inserted into the trigger point to: 

• Stimulate muscle relaxation

• Improve circulation

• Reduce pain and inflammation

  
  

This method can be highly effective for chronic muscle knots that do not respond to manual therapy alone.

3. Muscle Energy Techniques and PNF Stretching

These techniques involve gentle, controlled contractions of the muscle to: 

• Improve flexibility and range of motion 

• Restore normal muscle function

• Prevent trigger points from recurring

  
  

4. Laser Therapy for Pain Management

Some physiotherapists use low-level laser therapy to:

• Reduce inflammation in tight muscles 

• Enhance blood circulation 

• Speed up tissue healing

Treating the Root Cause to Prevent Recurrence

While trigger point therapy can provide immediate relief, identifying and treating the underlying cause is essential for long-term results.

Common Underlying Causes of Trigger Points

• Postural Imbalances

  Poor posture can place excess strain on certain muscles, leading to persistent trigger points. Physiotherapists provide postural assessments and corrective exercises to realign the body.

  
  

• Muscle Weakness or Instability

  If certain muscles are weak, other muscles overcompensate, leading to trigger point formation. Strengthening exercises help balance muscle function and prevent recurrence.

  
  

• Joint Dysfunction

  Restricted joints can cause muscles to tighten as a protective response. Physiotherapy includes joint mobilisation techniques to restore normal movement.

  
  

• Ergonomic Issues

  Improper desk setup, poor sleeping positions, or incorrect lifting techniques can trigger muscle imbalances. Physiotherapists provide ergonomic advice to reduce daily strain on the body.

  
  

• Nutritional and Lifestyle Factors

  Dehydration, vitamin deficiencies, or high stress levels can exacerbate muscle tightness. Physiotherapists may offer dietary and lifestyle recommendations to support muscle health.

  
  

By addressing the root causes, physiotherapy ensures long-term relief from trigger points and helps prevent them from returning.

How Do I Know If I Have a Trigger Point?

If you experience persistent muscle pain, tension, or limited movement, you may have active trigger points. Common signs include:

• Aching or burning pain in muscles

• Pain that radiates to other areas

• Restricted movement or stiffness 

• Sensitivity to touch in specific areas 

• Frequent tension headaches or neck pain

A physiotherapist can perform a detailed assessment to locate trigger points and develop a customised treatment plan to relieve discomfort.

Take the Next Step Towards Pain-Free Movement

Trigger points can cause ongoing discomfort and limit daily activities, but physiotherapy offers effective solutions for pain relief and muscle recovery.