Trigger Points: The Pain In Your Neck?

On a daily basis patients ask questions about trigger points: what exactly are they? How are they treated? What can I do to prevent them? The following article was written by Dr. Rich Berkowitz and published in our Fall '09 newsletter.



Life demands physical exertion. In response to this exertion, muscles are fatigued and become "tight". If prolonged, this tightness (called hypertonicity) can result in the formation of trigger points in the muscle. Trigger points are areas in muscles that are painful and tender when pressed upon. Trigger points can interfere with normal muscle function, restrict normal range of motion, and weaken the muscle. Trigger points can also refer pain to other areas; for example, a trigger point in your shoulder muscles can create a pain in your neck. These trigger points presenting themselves as pain may be associated with long term difficulties, deconditioning, and injury.

Both direct and indirect stimuli can result in the formation of trigger points. Direct stimuli include acute overload, overwork fatigue, gross trauma, or chilling. Indirect stimuli, such as other trigger points, visceral pain, arthritic joints, and emotional stress, can created these painful areas as well.

We regularly come in contact with these stimuli during our daily activities. Getting bumped from behind while driving and receiving a whiplash-type injury is an example of acute overload. The muscles in your neck are forced to contract quickly to prevent your head from traveling forward and backward. The sudden, forceful contraction of these muscles leads to the creation of tender areas, or trigger points.

Overwork fatigue can be the result of repetitive or sustained contraction, as one may find with poor posture. If this posture is assumed day in and day out, this may lead to hypertonicity of the muscles. Many occupations tend to create the postures (commonly seen in hairdressers and auto mechanics) due to the constant raising of the arms and bending at the trunk.

Trigger point therapy done by a licensed chiropractor can help relieve the pain and spasm. Using hand, finers, elbow, or a small instrument, the muscle is compressed with sustained pressure to relax it. In addition, proper instruction on body mechanics, gentle stretching, and adjustments of the spine and other joints can help to prevent trigger points from occuring. When used in conjunction with chiropratic treatments, trigger point therapy is a highly effective way to reduce muscle spasm, restore nomral range of motion, promote faster healing, and reduce pain and discomfort.