Trigger points are a painful and debilitating condition, often manifesting themselves in a person’s neck or back. Although someone with trigger points might say that they have “muscle knots,” and might even be able to feel “knots” under their skin, their muscles are not actually knotted. Instead, a trigger point develops when a small portion of myofascia (the tissue covering the muscle) tightly contracts and adheres to itself, cutting off its blood supply and preventing the underlying muscle from working correctly.

What causes trigger points?

There are many lifestyle factors that can lead someone to develop trigger points in the neck, middle back, or lower back, including the following:

• Injury to the muscle
• Overuse of the muscle
• Repeated stress on the muscle
• Poor posture
• Disuse of the muscle
• Sedentary lifestyle
• Vitamin deficiencies
• Sleep disturbances
• Joint disorders

What are the symptoms of trigger points?

Someone living with trigger points may experience the following symptoms:

• Pain (including headaches, neck pain and back pain)
• Numbness
• Muscle tenderness
• Muscle stiffness/tightness
• Decreased range of motion
• Fatigue

Notably, the pain resulting from a trigger point is localized, meaning that it will increase when pressure is applied to the area. It may also increase with use of the affected muscle, although patients may also experience persistent pain. The pain may come across as a burning sensation or as a dull ache. Additionally, one of the unique characteristics of trigger points, distinguishing them from tender points (sensitive spots in muscle, fat, or bursa), is that trigger points cause referred pain (pain that radiates from the trigger point into another area of the body). Trigger points can also mimic or further complicate other pain issues, such as disc pain or arthritis.

How can trigger point injections relieve my back pain?

It is important to promptly seek treatment for trigger points, as failing to do so can place undue stress on the surrounding muscles, eventually causing the development of additional trigger points. Many people find relief from trigger point pain by following a conservative course of treatment, potentially including pain medications, physical therapy, stretching or heat/cold therapy. If someone attempts treatments like these for several weeks or months and is unable to find relief, they may want to consider trigger point injections, another conservative treatment option, for their back pain. During this procedure, a medical professional injects a local anesthetic or saline, as well as a corticosteroid, into the patient’s trigger points, thereby inactivating the trigger points and relieving the patient’s pain. If the patient has certain drug allergies, the medical professional might instead use a “dry needling” technique, where they insert the needle into the affected muscle without injecting any medication, thereby easing muscle contraction and reducing inflammation. Trigger point injections can be given to patients with trigger points in the neck, upper/central back and lower back.

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