Trigger point – Qu’est-ce que le trigger point ? – Le blog de la rééducation et de la masso-kinésithérapie

Trigger point

Un point trigger myofascial ou point-détente est une zone très sensible, douloureuse ou hyper irritable, d’une grandeur de quelques millimètres, localisée dans un muscle strié ou dans son fascia. Très souvent présent sous forme latente, le point-gâchette provoque une raideur ou une restriction de mobilité lors d’activités normales. Une fois activé, il engendre une douleur, une …

Janet Travell to describe a clinical finding with the following characteristics:[ citation needed ] Pain related to a discrete, irritable point in skeletal muscle or fascia , not caused by acute local trauma , inflammation , degeneration , neoplasm or infection. The painful point can be felt as a nodule or band in the muscle, and a twitch response can be elicited on stimulation of the trigger point.

Patients can have a trigger point in their upper trapezius and when compressed feel pain in their forearm, hand and fingers S. They form as a local contraction in a small number of muscle fibers in a larger muscle or muscle bundle. These in turn can pull on tendons and ligaments associated with the muscle and can cause pain deep within a joint where there are no muscles.

The integrated hypothesis theory states that trigger points form from excessive release of acetylcholine which produces sustained depolarization of muscle fibers. Indeed, the trigger point has an abnormal biochemical composition with elevated concentrations of acetylcholine, noradrenaline and serotonin and a lower pH. This crisis of energy produces sensitizing substances that interact with some nociceptive pain nerves traversing in the local region which in turn can produce localized pain within the muscle at the neuromuscular junction Travell and Simons When trigger points are present in muscles there is often pain and weakness in the associated structures.

These pain patterns in muscles follow specific nerve pathways and have been readily mapped to allow for identification of the causative pain factor. Many trigger points have pain patterns that overlap, and some create reciprocal cyclic relationships that need to be treated extensively to remove them. Usually there is a taut band in muscles containing trigger points, and a hard nodule can be felt. Often a twitch response can be felt in the muscle by running your finger perpendicular to the muscle’s direction; this twitch response often activates the “all or nothing” response in a muscle that causes it to contract.

Pressing on an affected muscle can often refer pain. Clusters of trigger points are not uncommon in some of the larger muscles, such as the gluteus group gluteus maximus , gluteus medius , and gluteus minimus. Often there is a heat differential in the local area of a trigger point.

Further research is needed to test the reliability and validity of diagnostic criteria. Until reliable diagnostic criteria have been established, there is a need for greater transparency in research papers on how a case of MTrP pain syndrome is defined, and claims for effective interventions in treating the condition should be viewed with caution.

Scholars distinguish this from fibromyalgia , which is characterized by widespread pain and tenderness and is described as a central augmentation of nociception giving rise to deep tissue tenderness that includes muscles. Myofascial pain is associated with muscle tenderness that arises from trigger points, focal points of tenderness, a few millimeters in diameter, found at multiple sites in a muscle and the fascia of muscle tissue.

Biopsy tests found that trigger points were hyperirritable and electrically active muscle spindles in general muscle tissue. Referred pain from trigger points mimics the symptoms of a very long list of common maladies, but physicians, in weighing all the possible causes for a given condition, rarely consider a myofascial source.

The study of trigger points has not historically been part of medical education. Griner’s approach , mechanical vibration , pulsed ultrasound , electrostimulation , [15] ischemic compression , trigger-point-injection see below , dry-needling , “spray-and-stretch” using a cooling spray vapocoolant , low-level laser therapy and stretching techniques that invoke reciprocal inhibition within the musculoskeletal system.

Practitioners may use elbows, feet or various tools to direct pressure directly upon the trigger point, to avoid overuse of their hands. Fascia surrounding muscles should also be treated to elongate and resolve strain patterns, otherwise muscles will simply be returned to positions where trigger points are likely to re-develop. If trigger points are pressed too short a time, they may activate or remain active; if pressed too long or hard, they may be irritated or the muscle may be bruised, resulting in pain in the area treated.

This bruising may last for a 1—3 days after treatment, and may feel like, but is not similar to, delayed onset muscle soreness DOMS [ citation needed ], the pain felt days after overexerting muscles. Pain is also common after a massage if the practitioner uses pressure on unnoticed latent or active trigger points, or is not skilled in myofascial trigger point therapy. Researchers of evidence-based medicine concluded as of that evidence for the usefulness of trigger points in the diagnosis of fibromyalgia is thin.

In regards to injections with anesthetics, a low concentration, short acting local anesthetic such as procaine 0. High concentrations or long acting local anesthetics as well as epinephrine can cause muscle necrosis , while use of steroids can cause tissue damage. In , a study by Czech physician Karl Lewit reported that dry needling had the same success rate as anesthetic injections for the treatment of trigger points. He dubbed this the ‘needle effect’. It may lead to damage of soft tissue and other organs.

The trigger points in the upper quadratus lumborum , for instance, are very close to the kidneys and poorly administered treatment particularly injections may lead to kidney damage. Likewise, treating the masseter muscle may damage the salivary glands superficial to this muscle.

Trigger Points and Physical Therapy – Verywell Health

A trigger point describes a taut band of skeletal muscle located within a larger muscle group. Trigger points are tender to the touch and can refer pain to distant parts of the body. Patients may have regional, persistent pain resulting in a decreased range of motion in the affected muscles.   Massage, spray and stretch, and injections are a few techniques to decrease trigger point pain.

https://www.verywellhealth.com/trigger-point-2696165

Trigger Points: What is Trigger Point Therapy & How Does …

A trigger point is different from a sore or tight muscle because of its small size and being localized in the muscle’s fascia. It feels tender and painful when pressed on. It can also cause referred pain, which is pain it creates in a separate area.

https://www.drbodygadget.com/trigger-point-therapy/

Trigger points : Comment diminuer douleurs et …

Le trigger points passifs sont généralement provoqués par une mauvaise posture dans le travail ou la vie courante. Ils peuvent devenir actifs si les muscles concernés subissent une forte sollicitation ou un traumatisme. Les mauvaises postures et les trigger points. Si le développement de trigger points est si courant, c’est tout d’abord parce que de nombreuses personnes subissent les …

https://www.muscle-up.fr/trigger-point/

TRIGGER POINTS : THERAPEUTIQUE DES ALGIES & DE LA POSTURE

– Trigger points, posture et haines musulaires Réunion 2 :Séquen e Pratique – Durée : 1 heure – Méthode démonstrative et partiipative Objectif 2 : Connaître et comprendre les zones de référence des muscles les plus courants. Faire la différence entre les points actifs, les points latents. Savoir localiser et traiter les trigger points de façon précise en connaissant leur douleur …

https://www.epkmontpellier.fr/wp-content/uploads/2019/01/PRG_Trigger_Points.pdf

Méthode diagnostique et traitements des points trigger …

reguarding trigger points inactivation. To date, there are not enough studies about trigger points and non-specific chronic low back pain to affirm anything. New studies must show up to verify or deny hypothesis made in this work. Mots clés Trigger point actif Trigger point latent Lombalgie chronique récurrente. Inactivation

https://kinedoc.org/work/kinedoc/97c70611-7c5e-4e24-8bec-a726c1f469b7.pdf

Douleur et Acouphènes : Efficacité du trigger …

Trigger point

Un point trigger myofascial ou point-détente est une zone très sensible, douloureuse ou hyper irritable, d’une grandeur de quelques millimètres, localisée dans un muscle strié ou dans son fascia. Très souvent présent sous forme latente, le point-gâchette provoque une raideur ou une restriction de mobilité lors d’activités normales. Une fois activé, il engendre une douleur, une …

https://www.biorl.fr/blog/6168_douleur-et-acouphenes-efficacite-du-trigger-point-myofascial-ou-point-detente-pour-soulager-vos-acouphenes.html

Trigger Points Institut de Thérapie Manuelle et de …

Trigger point / Paris sud. 9 décembre 2021 – 10 décembre 2021 . Institut de Thérapie Manuelle et de Physiothérapie (ITMP), 40 Rue du Général Malleret Joinville, 94400 Vitry-sur-Seine, France. Aix en Provence. Trigger / Aix en Provence. 1 mai 2021 – 2 mai 2021 . Hôtel Campanile Aix Sud Pont de l’Arc, 1 Rue Jean Andreani, 13090 Aix-en-Provence . Trigger / Aix en Provence. 25 septembre …

https://www.itmp.fr/formations/trigger-points/

Trigger points – Overview & self-treatment

A trigger point is a small knot in your muscle. These muscle knots can cause pain where it originates or further away, in a spot that seems complete unconnected. Trigger points are responsible for a majority of all pain syndromes, especially that caused by myofascial trigger points.

https://www.muscle-joint-pain.com/trigger-points/

Trigger Points – Physiopedia

A Trigger Point (TrP) is a hyperirritable spot, a palpable nodule in the taut bands of the skeletal muscles’ fascia. Direct compression or muscle contraction can elicit jump sign, local tenderness, local twitch response and referred pain which usually responds with a pain pattern distant from the spot[1][2][3][4].

https://www.physio-pedia.com/Trigger_Points