Do your shoulders sneak up near your ears during stressful situations? Perhaps you’re plagued with nagging headaches that even the strongest pain relievers are incapable of conquering. Or maybe a classic case of shin splints has sidelined you from marathon training. If so, a technique called trigger point therapy might provide you with the relief you deserve.

Complementary and alternative medicines (CAM) have been steadily making their way into more mainstream practice as those suffering illness, pain and injury become disenchanted with traditional forms of therapy. According to the 2002 National Health Interview Survey (NHIS) conducted by the Centers for Disease Control (CDC), 36 percent of 31,000 respondents aged 18 and over acknowledged using some form of CAM. Twenty-eight percent of respondents noted their use of CAM was based on the belief that traditional treatments are ineffective. Doctors are also catching the buzz and have begun suggesting exercise and massage therapy instead of invasive and potentially harmful surgeries and prescription medicines. Vijay Vad, M.D., of the Hospital for Special Surgery in New York, discourages patients from back surgery (due to its lack of success) and refers them to such programs as yoga, Pilates and breath work.

“Lower back pain is really a mind-body problem, closely related to stress,” he says. Another, less known form of CAM that is growing in popularity is trigger point therapy (TPT), a pain relief technique developed by Dr. Janet Travell (who came to national attention after successfully treating low back pain symptoms for former president John F. Kennedy) in the 1940s. Travell believed that pain presented in one part of the body was initiated by injury or dysfunction in another, and that relief of that pain could be actuated by releasing pressure at those areas of injury or dysfunction.

Travell describes a trigger point as a small contraction knot or nodule in muscle tissue that develops as a result of injury, strain or overuse. These knots are often highly sensitive and refer pain to other areas of the body with or without external pressure. Persistent trigger point contraction places excess pressure on muscle attachments, which can lead to excessive wear and tear on joints, and premature degeneration of both soft- and hard-tissue structures. Headaches, neck and jaw pain, symptoms of carpal tunnel syndrome and low back pain are all considered results of these tiny contractions.

Pain is prevalent in the U.S. population. Eight out of 10 Americans are likely to suffer some sort of low back pain; an estimated 1.9 million Americans present with symptoms related to carpal tunnel syndrome; and approximately 10 million experience temporomandibular joint disorder (painful neuropathy centered around the neck and jaw). Whether resulting from acute trauma such as a car accident or a hard fall, or more subtle and longer-term soft tissue and joint degeneration as a result of poor posture, pain is a limiting factor in how we move through our day. Trigger points that develop in the neck and shoulders as a result of inefficient movement patterns (and brought on by activities as simple as opening the car door or reaching for a can of beans on the top shelf, for example) can significantly affect range of motion, making the most mundane daily tasks seem arduous. Gym-goers are highly likely to develop nagging trigger points due to poorly executed exercise techniques (lifting too much weight, poor form, etc.), which can have significant negative effects on a program’s success.

TPT is used to disable the neural messages that cause the trigger point and the pain. By interrupting these signals, the tiny contracture releases, pain disappears and full range of motion is regained. Several methods of trigger point therapy exist, such as transcutaneous electrical nerve stimulation (TENS), and ultrasound and laser. However, the most common are stretching, dry needling or injection, and manual massage.

Injection/dry needling: The most technical and difficult procedure requires injection of procaine into the trigger point, which interrupts the painful neural patterns, allowing area tension to decrease. Injection, however, can be unsuccessful, as it is a challenge to accurately pinpoint trigger points, which risks damage to nerves, blood vessels and organs. Needling also leaves supplemental soreness in the injection area.

Stretching: Travell considers application of a refrigerant spray and subsequent stretching to be an effective means for reducing trigger point pain, as it requires minimal skill, as opposed to injection. Stretching is of concern in that it’s possible to overstretch and damage muscle attachments, and it is difficult to ensure that the targeted muscle is being stretched.

Massage/myotherapy: Considered the safest and most effective means of therapy, massage is less invasive than needling and more exacting than stretch. Therapists also find this an optimal technique as clients/patients can be taught these techniques for continued use at home. Persons with sensitive fingers are said to have little trouble locating these taught nodules, and application of pressure will almost certainly result in an increase in pain production. According to Clair Davies, who is nationally certified in theraputic massage and bodywork, compression of a trigger point will cause the pain to radiate more fully, which is an indicator that the trigger point has been found. The trigger point is subsequently massaged with short, deep strokes several times throughout the day for optimal relief. Some trigger point therapists employ both massage and stretch.

Research with regard to the effectiveness of Travell’s techniques is limited; however, the growing acceptance of Eastern methods such as acupuncture has led to more discerning attempts to determine its viability. Most backup for TPT is anecdotal, and current research only alludes to the success of this method. Another factor to consider is that TPT is only considered effective as a continued practice. Many trigger point therapists help patients release tension and then give specific exercises to help re-educate the muscles to move in more efficient patterns. Much like chiropractic adjustments, however, trigger points are said to return if the patient’s faulty movement patterns are not interrupted and relearned. Despite thrice weekly TPT sessions, an office worker may continue to suffer from nagging headaches, earaches and eye strain if the worker doesn’t improve seated posture.

Despite popular consensus, pain is not an unavoidable aspect of life. It’s never too late to educate yourself and take advantage of the vast array of non-invasive methods for quality, pain-free living. Facilities and practitioners offering TPT are available throughout San Diego, and can bestow much-needed respite from the aches and pains of daily life. A knowledgeable professional who has undergone rigorous training (Don’t be afraid to ask about experience and education before purchasing sessions!) can help you to better understand the root cause of those aches and pains, which will help you take a more proactive approach toward relief. A variety of self-application manuals and textbooks is also available and can offer step-by-step instruction for accurately locating and massaging trigger points. Just Google “trigger point therapy” and you’re on your way!