Tuesday 6th August, 2019
  Categories: Practitioners

The relationship between latent (pain free) trigger points and depression

People with depression have lots of trigger points, and visa versa


A study published in the journal Clinical Rheumatology found that in pain free healthy adults the more depressed they were the more trigger points they had in the muscles of their upper back and across the top of their shoulders (and visa versa). In this article we discuss what that means for those with depression and those with trigger points


What are trigger points
Which causes which
What that means for you
Trial details

What are trigger points

Trigger points are those tender lumps in your muscles that shoot pain when therapists find them. We have a separate article on them elsewhere.

Cause vs effect
The study does not show which causes which: just that they exist together

Which causes which?

The study shows that depression and trigger points go together. That is, those with few trigger points tend to have little depression, while those with many trigger points have more depression. However, it doesn't say which causes which. The possibilities are:

  • trigger points cause depression
  • depression causes trigger points
  • they both have a common cause, or
  • a mixture of them all.

What it means for you

If you have large numbers of trigger points

This research means that you there is a risk of you suffering depression as well. Our expertise is in musculoskeletal conditions (eg. trigger points), so you should consider discussing this with a professional who deals with depression.

If you suffer from depression

This research suggests that you probably have multiple trigger points as well. This is our expertise, so we can advise you that these are arguably the largest cause of musculoskeletal pain such as back, neck and shoulder pain. We have linked below several useful resources, but do recommend you consult an appropriate professional.
What are trigger points
Video: How to treat trigger points
Article: Trigger point treatment

Trial details

76 students and health care workers were tested. None had any neck, shoulder or thoracic pain, and none were undergoing any psychiatric treatment.

Muscles examined

The examiners assessed the following muscles in the upper back and across the top of the shoulders for trigger points.

  • upper and middle trapezius,
  • serratus anterior, and
  • rhomboideus major and minor.

Measurement of depression

The level of depression symptoms was assessed using a questionnaire called the Beck Depression Inventory. When assessing the general population a score of 21 or over represents depression.


Prevalence of trigger points

60% of subjects had one or more latent (not causing pain) trigger points in the muscles examined.

Relationship with depression

To check the relationship between trigger points and depression the researchers grouped the people into three groups: no trigger points, a few trigger points and high numbers of trigger points. This is what they found.

No trigger points group
These had an average depression score of 8

Low trigger points group (1-5 trigger points)
This group had an average depression score of 10.3

High number of trigger points group (more than 5 trigger points)
This group had an average depression score of 28.5 Scores of 21 and above are considered clinical depression)


Çelik, D., & Mutlu, E. K. (2012). The relationship between latent trigger points and depression levels in healthy subjects. Clinical Rheumatology, 31(6), 907–911. https://doi.org/10.1007/S10067-012-1950-3

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Dr Graeme

About Dr Graeme

Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more

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