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Trigger Points and Pain

Trigger points are persistent, localized muscle spasms that can cause a great deal of pain. Trigger points alone may be responsible for many cases of neck pain, upper back pain, and lower back pain. This relationship is fairly common knowledge among physicians who treat pain, including chiropractors, rheumatologists, and physiatrists (doctors of physical medicine).
What is not generally known is that trigger points may also be implicated in radiating pain into the arm and hand or radiating pain into the leg and foot. In fact, radiating pain due to trigger points may be mistaken for pain caused by a herniated disc, in either the neck or lower back. Trigger point pain affecting the wrist and hand may even be misdiagnosed as carpal tunnel syndrome. A patient in whom a correct diagnosis of trigger point pain is missed may lose much precious time and other resources, as she fruitlessly "tries" one doctor after another and needlessly undergoes all sorts of complex and costly testing.
The key to correctly identifying the source and cause of upper or lower extremity radiating pain is to be able to accurately characterize its nature. Radiating pain caused by trigger points is diffuse - the pain broadly covers a region. This diffuse pain is described as "scleratogenous", meaning that it is pain referred from connective tissue such as muscle and tendon. Radiating pain caused by a compressed spinal nerve (ultimately caused by a herniated disc, for example) is described as "radicular" or "dermatomal". This pain is confined to a specific area - the area that is supplied by a specific spinal nerve. For example, pain involving the thumb and index finger could be caused by compression of the C6 spinal nerve. Pain involving the outside of the foot and the little toe could be caused by compression of the S1 spinal nerve.
Scleratogenous pain is not specific. A person might complain of pain across the "shawl" portion of the upper back and traveling into the upper arm, experienced "all over" the upper arm. Another person might be experiencing pain across the gluteal region, hip, and upper thigh. Both of these patterns of radiating pain are likely due to several trigger points, localized to the respective areas.
Of course, an accurate diagnosis is necessary to be able to develop an effective treatment strategy. The good news is that although trigger points necessarily represent a chronic muscular process, they may be treated with very good to excellent outcomes using conservative protocols. Chiropractic care is the optimal method for managing trigger point pain. Chiropractic care is a drug-free approach which directly addresses the biomechanical causes of these persistent trigger points and their associated patterns of radiating pain. Chiropractic care improves mobility and restores function, helping to reduce and resolve chronic pain.
1Alonso-Blanco C, et al: Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity. Clin J Pain Feb 28 2011 (Epub ahead of print)
2Bron C, et al: Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial. BMC Med 9:8, 2011 (January 24th)
3Renan-Ordine R, et al: Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial. J Orthop Sports Phys Ther 41(2):43-50, 2011

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Reviews By Our Satisfied Patients

    I have been going to Discover Life Chiropractic for 5 years. I am an athlete who went in with low back pain and some knee issues. It did take time but to this day I do not have low back pain or knee pain as long as I am staying healthy with periodic adjustments. Dr. Dave knows his stuff and is attentive to concerns (if you are feeling something make sure you tell him). I feel so aligned and feel like I am functioning at a high level each day. If I can, I like to use Dr. Daves partnering doctor for extremity adjustments (feet, arms, legs) he is exceptional especially with those! Like with anything you have to be consistent, can't just go 3 times and expect to be healed. Hope this was helpful! Best, Alex

    Alexandria B

    So... I have had back pain all my life and neck pain from a car accident causing severe and frequent migraines. Other chiropractors just did a "quick fix" that lasted a couple days at most. This chiropractor, David, has practically eliminated my neck pain and migraines and my back pain had decreased tons. Now usually when I have pain it is because I have bad posture or I need to stretch or build up muscle to keep my spine in place. I understand he can only do so much but to be pain free you have to put in work also. WITH ALL THAT SAID, the pain has gone down from constant to occasional and from severe pain to mostly mild and we are still working on it. Would recommend the chiropractic service there to anyone.

    Ken R

    I have experienced fairly sever neck pain for the last few years. Have been to my doctor, had ultrasounds etc. Nothing was working. I started going to David at Discover life a few months ago as a last resort to deal with the pain and the difference is amazing even with just this short amount of time. He explains everything very clearly and even has me doing stretching and work while at home. His staff is great and always friendly when I come in. I would highly recommend Discover Life Chiropractic.

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