TRIGGER POINT REFERRAL PATTERNS - HEAD AND NECK

Illustrations by Travell, Simons

& Simons’, Third edition. (2019)5

Illustrations by Travell, Simons

& Simons’, Third edition. (2019)5

Illustrations by Travell, Simons

& Simons’, Third edition. (2019)5

Illustrations by Travell, Simons

& Simons’, Third edition. (2019)5

At the Remedy Clinic, we understand the complex relationships between musculoskeletal trigger points and referred pain. We use a number of treatment options to greatly reduce or eliminate discomfort.

In 1942, Dr. Janet Travell first described myofascial trigger points as focal “knots” located in a taut band of skeletal muscle. When the taut band is palpated, it produces a characteristic referred pain in conjunction with local pain. Trigger points should not be confused with tender points (tender points produce a focal nodule that produces pain directly under the palpation but do not refer pain to a different area).

Trauma, or repetitive micro-trauma, leads to stress of muscle fiber and trigger points may develop.1,2 Microtraumas are caused by repetitive motion, including forward head posture (stiff raised shoulders and neck compression), poor sleeping posture, and raising arms for an extended period of time (construction workers, hairdressers and dentists). Pain and tightness at trigger points may cause decreased range of motion, stiffness, tinnitus, head, neck, ear and shoulder pain, TMJ pain, eye symptoms, wakening from sleep, and torticollis. Trigger points may also be associated with chronic musculoskeletal system disorders. 1,2

Patients can present with several trigger points throughout the musculoskeletal system. Different treatment modalities include physical manipulation, ultrasonography, and the Spray and Stretch techniques, all of which may be used to relive stress at the trigger point, thereby reducing referred pain.

Injections made directly into the trigger point (Trigger Point Injections, TPI) can greatly reduce or eliminate pain both at the injection site and at the referred location. 2 TPIs cause a temporary relaxation of the taut muscle cord, which allows for improved perfusion, ATP replenishment (causing lengthening of muscle fiber), and the removal of metabolite waste. TPIs disrupt the taut band and increase vascular supply can so the body can heal the muscle. 3,4 Lidocaine or Prolotherapy such as, sterile saline can be injected into the taut band. Trigger Point Injections using Lidocaine are performed at the Remedy Clinic so there is minimal to no discomfort for the patient.

Remedy Clinic

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Address:

370 Courthouse Rd, Suite 103, Gulfport, MS 39507