A trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle or in the muscle’s fascia (myofascial pain). This spot is painful on compression and can give rise to characteristic referred pain, tenderness and local twitch response. There are trigger points in other tissues also, such as skin, tendons, joint capsules, and ligaments.
There are many perpetuating/activating factors of trigger points such as:
- Trauma (local inflammation)
- Muscle injury & repetitive use
- Postural stresses (slouching, legs crossing, prolonged immobility)
- Emotional stress (Brain overload tightens the muscles)
- Constriction of muscles by wearing tight clothing, belts, wallet in back pocket, hanging purse on shoulder or sitting on the edge of the chair.
- Poor breathing techniques causing impaired circulation.
- Nutritional deficiencies due to poor diet
- Systemic problems
All these and more contributors can cause gradual or abrupt pain, limited range of motion, muscles stiffness, weakness, spasms, sleep disturbance, depression (due to chronic pain), imbalance, dizziness, tinnitus (ringing in the ears), nerve entrapment/compression, numbness & tingling.
Effective treatment of myofascial pain syndrome caused by trigger points usually involves dealing with the cause that activated the trigger points and correcting any perpetuating factors which often are different than what activated the trigger points. This helps the patient to restore and maintain normal muscle function.
IMPACT OF TMJ DISORDERS ON MYOFASCIAL TRIGGER POINTS
TMJ pain without actual inflammation can be contributed by face, neck, and cranial myofascial trigger points that refer pain to the joint and cause deep tissue hypersensitivity.
Some perpetuating/activating factors of these trigger points are:-
- Poor posture – excessive forward head posture, chronic mouth breathing
- Sudden forcible contraction of face/neck muscles
- Cracking ice between teeth
- Holding jaw in ‘stress’ position for long due to extreme emotional tension
- Nail biting
- Chewing gum
- Clamping of jaw on a mouthpiece or a pipe
- Dental procedures, and much more
Below are SOME of the TMJ trigger points and referred pain.
X – Trigger points
RED – Referral zones.
Myofascial pain and dysfunction can be debilitating and clinical massage therapy is beneficial on both evaluation and treatment. Overall benefits include promotion of healing process for injuries, increase in metabolism, boosting immunity, better range of motion, improved circulation, enhancement in joint and muscle function.