Trigger points are known as tender nodes of degenerated muscle tissue causing local and radiating pain that may be bound to a single muscle or to several muscle groups. Their structure consists of small-circumscribed hyperirritable foci in muscles and fascia, often found within a firm or taut band of skeletal muscles. Trigger points may also occur in ligaments, tendons, joint capsule, skin, and periosteum. When palpating a trigger point, a local or referred pain pattern may be elicited causing a variety of symptoms including pain, muscle weakness, decreased joint motion, paresthesia, along with autonomic symptoms. Trigger points which are located in the head and neck can cause proprioceptive instabilities such as problems with balance, dizziness, and tinnitus. Trigger points are classified as primary, secondary, satellite, active, or latent (1)
Primary trigger points develop independently and not as the result of trigger point activity elsewhere.
Secondary trigger points may develop in antagonistic muscles and neighboring protective muscles as a consequence of stress and muscle spasm. It is commonly experienced in patients after primary trigger point elimination.
Satellite trigger points may develop in the area of referred pain as a result of persistent resting motor unit activity in the muscle. Multiplication of trigger points results from the development of secondary and satellite trigger points. This chain reaction of trigger point multiplication may be elicited by many factors, including muscle weakness, tension, and postural abnormalities. (1)
Active trigger points are considered tender, painful, and symptomatic with pain at rest and during motion. There are two common reactions seen in patients when palpating active ...
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...ubjects with active trigger points in the muscle have a biochemical milieu of selected inflammatory mediators, neuropeptides, cytokines, and catecholamines unlike those in subjects complaining of latent or absent trigger points. (6)
3. Causes of Trigger Points
Janet Travell and David Simons have confirmed that the following factors can help maintain and enhance trigger point activity:
• Nutritional deficiency, especially vitamin C, B-complex and iron
• Hormonal imbalances (low thyroid, menopausal or premenstrual situations, for example)
• Infections (bacteria, viruses or yeast)
• Allergies (wheat and dairy in particular)
• Low oxygenation of tissues
The repercussions of trigger point activity are far from a simple musculoskeletal pain. They can be accompanied with hyperventilation and chronic fatigue as well as apparent pelvic inflammatory disease (5)
The immunologic events that are happening at the local level during Carlton's acute inflammatory response would be:
The first activity was isolating the gastrocnemius muscle. A cut between the thigh and hip was made so the skin can be pulled down past the lower leg. Then the tendon was cut away from the bone of the heel and one end of the nine-inch string was tied to the tendon. This led to the isolation of the sciatic nerve, found between the hamstring and heel on the lateral side of the thigh. Using fingers, the seams along the quadriceps and hamstring underwent a blunt dissection. In doing so, the glass-dissecting probe was used to free the sciatic nerve embedded in the tissues. A four-inch string was inserted between the nerve and the tissues. Then the transducer was calibrated using a fifty-gram block under the “Frog Muscle” program. Parameter of CAL 1 was changed to zero grams and CAL 2 was changed
...st the sacrolemma will depolarized, thus activation potentials along the T-tubules. This signal will transmit from along the T-tubules to sarcroplasmic reticulum's terminal sacs. Next, sarcoplasmic reticulum will release the calcium into the sarcroplasm leading to the next second event called contraction. The released calcium ions will now bind to troponin. This will cause the inhibition of actin and mysoin interaction to be released. The crossbridge of myosin filaments that are attached to the actin filaments, thus causing tension to be exerted and the muscles will shorten by sliding filament mechanism. The last event is called Relaxation. After the sliding of the filament mechanism, the calcium will be slowly pumped back into the scaroplasmic reticulum. The crossbridges will detach from the filaments. The inhibition of the actin and myosin will go back to normal.
The signs and symptoms are pressure, stiffness, pain in the chest or/ and arms that may advanced to the neck, jaw, or back
which play the important role to call for people’ alertness, should have sharp and acute
The flexor tendons are not involved, although it may appear so in advanced contractions. Trauma may accelerate and in some cases even begin the process.
In the United States 54 million people have a disability and only 15 percent were born with a disability (Jaeger & Bowman, 2005). If a person lives long enough, it is statistically likely that they will develop some kind of disability in their advancing years (Jaeger & Bowman, 2005). At some point in your life you could have experience a fractured bone, a minor cut, or had some type of surgery. Imagine after some minor injury that you may not even remember and then experiencing a constant pain so agonizing that no amount of pain medication can make you comfortable (Lang & Moskovitz, 2003). Some additional symptoms that you may also experience are severe burning pain, changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch (Juris, 2005). These symptoms are associated with a disease that is called Reflex Sympathetic Dystrophy (RSD) but more recently termed as complex regional pain syndrome, type 1 (CRPS 1) (Juris, 2005). For simplification purposes this disease will be referred to as RSD throughout this paper.
When a receptor is activated and the stimulus is taken to the hypothalamus and then relayed out to the “limbic system and neocortical areas…impulses stimulate the neuroendocrine and autonomic nervous system,” which can cause an array of issues if not careful and if the stress signal is prolonged. (3)
Musculoskeletal pain affects the bones, muscles, ligaments, tendons and nerves, its commonly but not always it is caused by physical injury, which can be widespread or localised in just one body part. Joint and muscle pain is the probably the number one symptom that prompts people to seek the help of health professionals like osteopaths.
Because symptoms are wide - ranged and studies for treatment of FMS did not begin until the 1980's, it is one of the most popularly misdiagnosed conditions in the medical world. The main symptoms are widespread pain and fatigue as well as tender points on the body. The muscular pain often may feel like a pulled muscle and may burn or twitch. (Source 3)
In each zone, impulses and reflexes travel until they reach nerve endings in the feet and the hands. These zones are believed to be meridians along which energy flows. Placing pressure on the nerve endings in the hands and the feet will affect the organs found in that particular zone (http://www.reflexology.org/aor/refinfo/healart.htm). As well as longitudinal zones throughout the body, there are also cross-reflex points. These cross-reflex points are corresponding points on the opposite side of the body which can be useful in administering reflexology treatment when pressure is not able to be placed on the reflex point....
Hasenbring, M.I., Rusu, A.C., & Turk, D.C. (2012). From Acute to Chronic Back Pain: risk factors, mechanisms, and clinical implications: Oxford: OUP Oxford.
• Pain: Impingement syndrome begets an aching pain in both the front of the shoulder and also the outer side of the upper arm. The pain will increase on contact as it is tender to the touch, and also certain movements will result in sharp searing pain.
in soft tissue mobilization pressure.” Medicine and Science in Sports and Exercise. April 1999: 531-5.