Abstract

Trigger points are defined as discrete, focal, hyperirritable spots located in a taut band of skeletal muscle and their ligamentous junctions remote from the site of the pain. They are prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of trigger points is an important part of musculoskeletal rehabilitation of regional axial and limb pain syndrome. Acute trauma or repetitive microtrauma may lead to the development of stress on muscle fibers and formation of trigger points. Patients may have regional, persistent pain resulting in a limited range of motion in the affected muscles. Pain from myofascial trigger points can be identified by careful history taking and skillful physical examination, and they are quickly responsive to physical and medical management in the absence of serious perpetuating factors. Skeletal muscle makes up nearly half of body weight. Each of the approximately 500 skeletal muscles is subject to acute and chronic strain. Each muscle can develop myofascial trigger points and has its own characteristic pattern of referred pain. Palpation of a hypersensitive bundle or nodule of muscle fiber is harder than normal consistency and elicit pain directly over the affected area and/or cause referred pain and local twitch response. Trigger point injection has been shown to be one of the most effective treatment modalities to inactivate trigger points and provide prompt relief of symptoms.