The topic of back pain seems endless. In one of my previous articles, we analyzed this problem from a less common perspective, namely that of the muscles affected by the trigger points. Thus, two other important aspects follow from this topic: how to diagnose and treat trigger points.
No matter how much I talk about the seriousness and complexity of the problem, there are always people who, after hearing about the trigger points for the first time, support the same theory – that no diagnosis is needed to treat them. Moreover, they claim that it is not a cause for concern, you just have to do a general massage or simply strengthen the muscles and thus you will eliminate all the trigger points.
Is it that simple? Not really.
I think you will realize this from the answers to some of the most frequently asked questions about diagnosing trigger points.
How do we know where the pain is coming from and where are the trigger points located?
To some extent, the patient's sensations help to find out, but …
First of all, let's not forget that pain is reflected, which means that the place where the patient is pointing may not coincide with the real source of pain. Secondly, the patient only points to the painful area, and not to a specific muscle. Also, let's not forget that the muscles are located in layers. Therefore, where the patient is pointing, there may be not one, but several different muscles.
As a rule, patient complaints are only a reference for finding a trigger point, but in no way the place of its real localization.
Can trigger points be diagnosed by pressing? Where do you feel pain means there is a trigger point?
Yes, there is indeed a similar way, but only as the "final method" to make sure that the doctor has found exactly the trigger. Palpation is the final stage of diagnosis, when the trigger point has already been found and it remains only to determine its epicenter. In fact, palpation is a smooth transition from diagnosis to treatment.
Maybe it's not worth bothering to look for each trigger point, but just a general massage of the whole body will solve the problem?
This is not the best idea at all. Massage therapists are not trained to diagnose or treat trigger points. This is the skill of chiropractors. Treatment of trigger points requires certain knowledge and specific influences. Therefore, it is impossible to remove trigger points with a simple massage. In addition, they still need to be detected, so one cannot do without diagnosing the trigger point.
So, how to diagnose trigger points correctly?
For the diagnosis of trigger points none of these moments will be omitted:
- The patient tells the doctor about his pain – this is an interview with the patient.
- The doctor examines the patient statically – visual diagnosis.
- The doctor examines the patient in dynamics – kinesiological diagnosis.
- The doctor checks the reaction and strength of the muscles – manual testing of the muscles.
- The doctor checks the reflexes, sensitivity and coordination – neurological diagnoses.
- The doctor palpates the detected trigger point to reveal its epicenter.
Now that you have learned how to correctly diagnose trigger points, let's move on to treatment methods.
First of all, here we will talk about your safety, because not all methods of treating trigger points are equally harmless.
Mild manual therapyis the safest and most effective way to treat triggers. However, gentle manual therapy, due to its effectiveness, safety and delicacy, requires more time and effort from the doctor.
There are also special devices for the treatment of trigger points, for example, shock wave therapy (SWT), which is so popular now. From a safety point of view, it is practically harmless.
Another method of treatment is the trigger points injection. From the safety point of view, this method is not in the first place, because there is always the risk of puncturing a vein, an artery or any other organ. Especially if the trigger point is in the chest, lower back or neck.
But anyway, when choosing a method for treating trigger points, you should not miss the main thing: it is not the method that heals, but the doctor. In the right hands, all methods are effective and safe.