Trigger points in the back (often mistakenly referred to as “knotted muscles”) can cause pain that manifests itself in various other areas of the body. A trigger point develops in the back when the tissue covering the back muscle at issue contracts and adheres to itself. When this happens, the blood supply to the tissue is cut off, causing pain and preventing the underlying muscle from performing the way it should.

Trigger points are unique in that they can cause referred pain, which radiates into other areas of the body when surrounding nerves are irritated. Trigger points in the thoracic (middle) region of the spine may cause pain in a number of muscles, making it difficult for individuals to perform routine tasks. These trigger points have two phases:

• Active — Pain is constant and debilitating

• Latent — Pain is not felt unless pressure is applied to the area surrounding the trigger point

Although trigger points in the latent phase may not cause pain, they still may cause stiffness, weakness and decreased range of motion. Trigger points may remain in the latent phase for years after a person appears to have recovered, and can transition back into the active phase for any number of reasons, including re-injury, fatigue and stress.

If you have a trigger point in the back, and particularly one that is causing you debilitating pain, you may benefit from trigger point injections. These injections, which contain a corticosteroid and either saline or a local anesthetic, can help to relieve pain in the back by inactivating the trigger point (or points) at issue. If you have a history of drug allergies (especially any relating to cortisone or local anesthetics), you could instead benefit from dry needling, where the medical professional inserts a needle into the back muscle at issue without injecting any medication.