Osteopathic treatment of trigger points

Trigger points are very tender areas within a muscle and are commonly divided into two types: active and latent. Active trigger points cause pain locally and can also refer pain to other parts of the body when pressure is applied. This referred pain can sometimes be felt some distance away from the trigger point itself. For example, trigger points in the gluteal muscles can refer pain down the leg and into the calf, sometimes mimicking sciatic-type pain.

Latent trigger points, by contrast, tend to cause pain only when pressed directly. They are often associated with stiffness, reduced joint movement and long-standing muscle tension, and can become more common with increasing age. Trigger points may develop for a variety of reasons, including sustained poor posture, birth-related strain, injury or trauma, repetitive overuse or sudden over-exertion.

Trigger points are not the same as acupuncture or acupressure points. They can usually be felt directly within the muscle and are often described as tight or “knotted” areas. They may be present in people with more widespread pain conditions, such as myofascial pain syndromes or fibromyalgia, where they can contribute to significant discomfort and reduced function.

Osteopaths and other manual therapists frequently assess and treat trigger points as part of a broader musculoskeletal approach. Treatment may involve a combination of hands-on techniques such as sustained pressure to the trigger point, soft tissue techniques and massage, joint articulation and movement-based approaches. The aim is to reduce pain, improve muscle function and restore normal movement patterns. In some longer-standing or persistent cases, addressing trigger points can be an important part of treatment where symptoms have not fully settled with other approaches.

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