Myofascial trigger points represent a major cause of sustained pain, as well as muscular, nervous system, and soft tissue dysfunction. Extensive research and experiential results show that all chronic pain conditions produce trigger points.

Myofascial Trigger Point Therapy is a proven technique used for the relief of soft-tissue pain and dysfunction. It is used by many healthcare practitioners, including medical doctors, osteopaths, chiropractors, and massage therapists. Often called a Neuromuscular Technique (NMT), NMT actually encompasses a broader set of treatment approaches.

Myofascial trigger points represent small areas of tightness within muscles, creating tight bands and "knots" or tiny bumps from the contracted muscle fibers. Current literature indicates that nerve impulses to these muscle fibers will not "shut off" and that myofascial trigger points require some form of manual intervention to help them release.

All trigger points cause discomfort when pressed; however, "active" trigger points frequently refer pain to other areas of the body. As a result, many therapists address the site of the pain, or the symptoms of trigger points, rather than the real problem area, or the site of the trigger point.

Pressure to an active trigger point will typically refer the sensation or symptoms to a distinct and predictable target area. In addition to pain, the effects of an active trigger point can include:

• Limited range of motion
• Muscle weakness
• Numbness or tingling

Since an active trigger point refers pain to reference sites, it may invoke satellite, or secondary trigger points. As a result, acute conditions tend to turn chronic, and chronic conditions tend to get worse over time.

In Western medicine, documented research on trigger points dates back to 1841. However, most references give credit to Janet Travell, M.D., for the most extensive clinical research on Myofascial Trigger Point Therapy.

Dr. Janet Travell was the White House physician during the Kennedy and Johnson administrations. She treated President Kennedy for debilitating myofascial pain that threatened to end his political career before he entered the White House.

Janet Travell first coined the term "myofascial trigger point" in print in 1942. She co-authored several books with David Simons, MD, who continues to promote research about trigger points and to update their works as more research and information surfaces. Most people consider these books the definitive reference on trigger point therapy.

A more generic definition for Myofascial Trigger Point Therapy would be specific ischemic pressure. This involves pushing a point on the body hard enough to stimulate the nervous system and increase circulation to the area. Western research indicates an 80% overlap between myofascial trigger point and acupressure point sites on the body. In Oriental medicine, practitioners have practiced acupressure to relieve pain for thousands of years.

Leon Chaitow, O.D. has published a great deal of information on European-based NMT and trigger point therapies. He recently joined with American NMT practitioners to publish more comprehensive references on NMT and Myofascial Trigger Point Therapy, incorporating both American and European techniques.

Another form of Western trigger point therapy is Periostal Trigger Point Therapy, also known as Periostal Massage. It focuses on the connective tissue that surrounds bone tissue - the periosteum.

In the 1950's, Periostal Massage was recognized as an independent procedure of medical massage. Disease to the joints and inner organs cause pathological changes in the periosteum, such as local thickening and roughness.

Therapeutic effects of Periostal Massage include:

• Elimination of local pain
• Improved circulation to the periosteum
• Delayed degeneration of joints
• Improved function of specific inner organs

Periostal Trigger Points may also cause local pain at the trigger point sites.