Trigger points are those tight tender spots in muscles that masseurs love to find. They are said to be “active” when they are causing pain, often being a major cause chronic pain syndromes such as neck, shoulder and back pain. However, as anyone who has had a masseur find these tender spots they never knew they had would understand they can be there within tightened muscles but only produce pain when pressed upon. These are known as “latent” trigger points. They are extremely common, with one study finding that nearly 90% of pain free adults have them in their shoulder muscles alone.
The obvious consequence of latent trigger points is that they are aggravated becoming “active” causing pain. However, a study published in the journal Pain Medicine 2011 showed that they also cause rapid fatigue and pain upon exertion. This is not surprising, as scientists have found that trigger points are actually parts of the muscle that have tightened (in spasm) and unable to relax. As such, they are already “pre-fatigued with restricted blood flow, a lack of oxygen and a build up of waste products.
Given these findings, and that nearly 90% of pain free adults have them in their shoulders alone, latent trigger points would be a major cause of rapid fatigue and muscle pains upon exertion. Unexplained fatigue can have serious causes so a health care professional should be consulted. However, however, they don’t show up in laboratory tests or an x/rays so they are too often overlooked, with patients too often undergo a battery of medical tests looking for other causes while overlooking this extremely common one. What does one do then if suffering from unexplained fatigue? One option would be to consult a professional who is able to check and ensure that there is no serious problem, then if nothing was found then consult a professional who deals with trigger points. Alternatively, there are professionals who understand and are able to address trigger points, but recognise when issues are present that need referral elsewhere.
Practical considerations for treating trigger points
Trigger points are often treated when they are causing pain, ie. “active”. The relief is usually most appreciated. However, when this happens the trigger points don’t usually disappear. They simply revert back to being latent where they only cause pain when aggravated, and has been shown by this research cause other problems such as fatigue. Research has shown that the elimination of trigger points altogether is a lot more difficult, taking a great number of applications of therapy over a long period of time. This is discussed in more detail elsewhere, but if done by professionals alone it can be so expensive and time consuming as to be unpractical or unaffordable. This is one of the main reasons our serious massagers for home usage were built, enabling practically unlimited soft tissue therapy at home under professional advice.
Ge HY1, Arendt-Nielsen L, Madeleine P. Accelerated muscle fatigability of latent myofascial trigger points in humans. Pain Med. 2012 Jul;13(7):957-64
As discussed, trigger points are extremely common and result in fatigue, yet are largely undiagnosed. This can result in a battery of futile tests while the real cause is overlooked. We do not recommend that fatigue be self diagnosed and managed, however, we encourage you to share this information with your health care professional. Download the .pdf of the practitioner version of this summary: Download