Trigger point therapy

Trigger point is a redirect to this article. For the data processing term trigger point, see trigger point (virtual reality) .

Trigger point in the trapezius muscle

The goal of trigger point therapy is to eliminate the pain of so-called myofascial trigger points . These are locally limited muscle hardening in the skeletal muscles , which are locally sensitive to pressure and from which pain can be transmitted . Around 80 to 90% of pain syndromes are said to be due to such hardening of the muscles.

Myofascial trigger points in the shoulder lifter muscle ( levator scapulae muscle ) and in the trapezius muscle ( trapezius muscle ), which can trigger pain in the neck and back of the head / temple area , are also in most cases the trigger for those pain symptoms. The therapeutic options are mainly aimed at the targeted reduction (deactivation) of the permanently contracted muscle fibers as well as the subsequent sustainable prophylaxis of these muscles that are permanently shortened or incorrectly stressed due to an unfavorable working posture or poor training condition. As possibilities exist depending on the affected muscle: specific manual physiotherapy techniques, treatment by acupressure in self-treatment , dry needling ( dry needling ) the trigger point with acupuncture needles or by injection of a local anesthetic into the trigger point, but also a trigger shock wave therapy .

therapy

The treatment of trigger points is carried out by specially trained specialists such as doctors, physiotherapists, physiotherapists, occupational therapists or masseurs. A trigger therapist is trained to use a finding (consisting of anamnesis, inspection and stretch tests) to narrow down the corresponding trigger points and to reduce them systematically and effectively in the course of the subsequent treatment. The therapeutic effect can be felt immediately. During the treatment, the patient's pain picture is reproduced, thus allowing empirical evidence of the associations between the pain picture and the muscle.

Scientific study situation

New Zealand researchers came to the conclusion in a review article from 2009 that there is no standardized scheme for detecting the myofascial trigger points. Literature data would therefore show contradicting data for recognizing such points. As early as 2008, Danish researchers pointed out what they considered to be a poor methodological quality of the literature on myofascial trigger points. There is no reliable proof of efficacy that can be derived from the literature for the use of injections at the trigger points.

Tense muscle fiber bundles (hard tension) and trigger points can also be visualized with the help of imaging methods from elastography , which show the differences between trigger points and the surrounding tissue. This has been demonstrated in scientific studies using ultrasound elastography (elastographic sonography), especially vibration sonography, in which an external vibration source is used in addition to Doppler or duplex sonography . Hart tensioning strands can also by magnetic resonance detected Elastography.

See also

• Acupressure
• Dry needling acupuncture
• Muscle hardening / myogelosis
• Extracorporeal shock wave therapy
• Tension

literature

• Roland Gautschi: Manual trigger point therapy . Thieme Verlag, Stuttgart u. a. 2010, ISBN 978-3-13-147471-1 .
• Janet G. Travell (Ed.): Manual of Muscle Trigger Points .
  • Part: Upper extremity, head and trunk. 2nd, revised edition. Urban & Fischer, Munich a. a. 2001, ISBN 3-437-41402-X .
  • Part: lower extremity and pelvis . Urban & Fischer, Munich a. a. 2000, ISBN 3-437-41401-1 .
• Wolfgang Bauermeister: Pain-free through trigger osteopractic - the unique diagnostic and healing method for head, neck and back pain, shoulder and knee injuries; also for self-treatment . Südwest Verlag, Munich 2005, ISBN 3-517-06947-7 .
• Clair Davies, Amber Davies: Workbook Trigger Point Therapy - The Proven Method for Relieving Muscle Pain . With an introduction by David G. Simons. Junfermannsche Verlagsbuchhandlung, Paderborn 2008, ISBN 978-3-87387-677-4 .

Web links

• Thomas Winter: Trigger Point Osteopractic. In: Lexicon of forms of therapy and diagnosis , on gesunder-mensch.de

Individual evidence

1. ↑ About trigger points and trigger point therapy: Manual trigger point therapy and dry needling
2. ↑ N. Lucas, P. Macaskill, L. Irwig, R. Moran, N. Bogduk: Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review of the literature. In: Clin J Pain. , 25 (1), Jan 2009, pp. 80-89.
3. ^ C. Myburgh, AH Larsen, J. Hartvigsen: A systematic, critical review of manual palpation for identifying myofascial trigger points: evidence and clinical significance. In: Arch Phys Med Rehabil. , 89 (6), Jun 2008, pp. 1169-1176.
4. ^ NA Scott, B. Guo, PM Barton, RD Gerwin: Trigger point injections for chronic non-malignant musculoskeletal pain: a systematic review. In: Pain Med. , 10 (1), Jan 2009, pp. 54-69. Epub 2008 Nov 5.
5. ↑ Hans Ulrich Hecker, Angelika Steveling, Elmar T. Peuker, Kay Liebchen: Pocket Atlas Acupuncture and Trigger Points , Haug Fachbuch, 2015, ISBN 978-3-8304-7842-3 . P. 213 .
6. ^ DG Simons: New views of myofascial trigger points: etiology and diagnosis . In: Archives of Physical Medicine and Rehabilitation . tape 89 , no. 1 , 2008, p. 157-159 , doi : 10.1016 / j.apmr.2007.11.016 , PMID 18164347 .