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Trigger points must become deactivated or their effect will linger and
become chronic. Then they will extend their activity by activating other
trigger points.
A thorough physical examination should be performed, with a
focus on the area of pain and discomfort. Your therapist should start
by observing the your movements and posture, looking for poor posture,
muscle strain, pain that increases guarding, and increased pain in other
muscle groups. Trigger points cause muscle shortening with secondary
weakness and decreased range of motion which can be observed. A
musculoskeletal exam with strength testing and relevant neurological
assessment is often preformed. It is important in your examination that
careful examination of the total body is carried out. During the examination
it is important to talk with the patient and enquire whether they have had
any physical injury, strain, knock, bump and so on. A bruise may not
necessarily manifest itself visually and since part of the discomfort from a
bruise is the broken blood vessels or capillaries which give the
discoloration it may require different treatment to acupressure; one should
be careful not to be misled in diagnosis. Time is well spent in diagnosis so
that the correct treatment is carried out
Direct pressure with the finger, fingers or thumb are all
very penetrating movements. Pressure is magnified many times when applied in
this manner. The hyperaemia this produces will last for several hours
causing capillary dilation to be retained while excess blood and oxygen
softens and prepares the spasm for cross-fibre friction.
A Typical Treatment Session
To facilitate the identification of trigger points, the you should be as
relaxed as possible. Trigger points can be felt by palpating the muscles;
trigger points will consist of tender, hard (or ropy) knots or nodules
surrounded by what feels like normal muscle tissue. Once a trigger point has
been found, the local twitch response may be elicited as muscle or skin
twitching. You should feel sour or numb, but not knife-cut like pain when
the trigger point is pressed. Be sure to speak out about any pain
experienced by wincing or verbalizing this should be encourage before
starting, if treating yourself you will know when you find one. The
trigger points are usually between or beside the bones and tendons or
ligaments, on a depression, never on the bones or blood vessels. Next, the
patient should be evaluated for referred pain. Knowledge of reference zones
is essential to the diagnosis.
Be that as it may, it is essential that no trigger
point is missed as just missing one trigger point may well reactivate the
original problem. The slight discomfort experienced during examination is
well worth while enduring to ensure the long term relief correct treatment
will provide. But is should be slight, if it "hurts" lighten the pressure.
The whole area of pain should be palpated for trigger
points, tight bands occurring most likely at the edges of muscle and
ensure that the adjoining zone of radiation is thoroughly examined to ensure
no satellite trigger point has been missed.
Nonetheless be aware that obvious nerve root pain may also
at the same time exhibit less obvious myofascial trigger point pain and vice
versa. It is wise, even if in doubt, to treat the trigger point with
acupressure.
It is by experience and correct use of the hands that one can “feel†| |
