"Trigger points and symptoms of back pain."
By Tommy Hoffman, Licensed Physical Therapist
So you think you have a trigger point? Perhaps you can feel a “knot” or “nodule” directly under the skin in the muscle(s) of your lower back? Perhaps the area is warmer than that of the surrounding soft tissue? Is there a lot of extra pain when pressure is applied to the hurtful area? Does it refer pain to other parts of the body?
A trigger point may be defined as an over stimulated muscle fiber (sacromere) existing in a contracted state which it is unable to release. And this can be quite painful!
As you may have answered yes to any one of the above questions, you may indeed have a trigger point or multiple trigger points. The proper diagnosis of a trigger point can be difficult at times to achieve by your primary care physician because trigger points are not visible on x-rays. There is also the matter of properly distinguishing the difference between a “trigger point” and a “tender point”.
The biggest difference between the two is that trigger points refer pain elsewhere to other parts of the body while tender points are strictly a pain that occurs locally. It is important to note that Fibromyalgia Syndrome often involves both trigger points and tender points.
One should also be careful not to confuse a muscle spasm with a trigger point. A muscle spasm is a violent contraction of the whole muscle, where a trigger point is a contraction in only a small part of the muscle. And while stretching a muscle spasm can feel good, it is often more painful when performed on a muscle with a trigger point. So stretching a hurtful lower back with trigger points is something you want to avoid.
Treatment options are somewhat limited due to the resilient nature of a trigger point. Most often, moist hot packs yield only temporary relief for lower back pain due to trigger points or “knots”. Most individuals ultimately do well with either trigger point injections and/or deep stroking massage techniques. Deep stroking massage can be performed as a self treatment, and may be worth exploring on your own. You can find information about deep stroking massages on the internet.
Before attempting any sort of self treatment, seek the advice of a medical professional for the proper diagnosis of your condition.
Good Luck,
Tommy Hoffman, P.T.
