Many people suffer from shoulder pain that does not respond to treatment. The authors of two clinical trials looked at the conditions most commonly diagnosed as the cause of pain. They stated that these conditions were just as common in those without pain, and further that clinical trials failed to show that treating these conditions helped. Searching for the real cause the researchers investigated trigger points in muscles (see below). They found that those suffering shoulder pain had a large number of these, and that treating them gave considerable relief.
What is a trigger point
Trigger points are those ender lumps in muscles that shoot pain and masseurs love to find. They are discussed in more detail elsewhere in this website. In summary though they are parts of the muscles that have gone into spasm and will not relax, causing the muscle to tighten and blood flow to be restricted.
Painful vs pain free trigger points
Trigger points that do not cause pain until a masseur presses upon them are known as Latent (pain free) trigger points. If they shoot pain without provocation they are know as Active trigger points. It is important to understand that these are the same trigger points. For example, a latent trigger point may be aggravated and start shooting pain (becoming active). After resting the trigger point may settle and stop shooting pain (becoming latent). As similar thing may happen in reverse with treatment. When treated an active trigger point is treated it may stop shooting pain, becoming a latent trigger point and giving welcome relief. Later that trigger point may be aggravated again and start shooting pain.
Who was tested
The trial was conducted on 72 adults, each of who had suffered from shoulder pain for at least six months.
What they did
Each person had 12 therapy sessions over 12 weeks. The researchers were investigating whether trigger points caused shoulder pain, not the best treatment for trigger points, so they wanted to do everything possible to eliminate the trigger points. Each session patients were given multiple applications of multiple therapies. This is much more than would be received during most professional consultations.
The three main findings were:
- shoulder pain improved considerably
- the number of trigger points reduced
- the reduction in pain corresponded to the the reduction in trigger points. In other words, as the trigger points went the pain went.
Trigger points are stubborn
Although the number of trigger points reduced the results show that only about 1/3 were completely eliminated. Many had reverted back to their latent (pain free) state, but about 2/3 still remained. As well as 2/3 still being present the researched stated that causative and aggravating factors may cause the trigger points to redevelop. They further stated that many researchers believe that trigger points have microscopic damage that may cause them to return. In other words, although sufferers gained excellent relief the underlying issue was far from gone, and likely needed many more therapy sessions.
Practical treatment of shoulder pain
The results of this research clearly show that trigger points are the major cause of shoulder pain, and their treatment provided excellent relief. However, 12 sessions of very extensive therapy only eliminated 1/3 of the trigger points, with the researchers believing they may gradually return. The correct treatment for most shoulder pain is trigger point therapy, but the results of this trial indicate that a very large number of sessions of therapy would be needed over a long period of time. If done by professionals alone this would be prohibitively expensive for most. What is the solution?
The treatment of trigger points is discussed elsewhere on this website. In summary though application of vibration using our General Purpose Massager is excellent therapy, and can be done at home to supplement professional care. This makes effective treatment of trigger points and shoulder pain affordable.
For more detailed information and references please see the practitioner version of this article.