Trigger Point Therapy: What Does a Muscle Knot Do?

1. What Is It Actually?

A trigger point is a small, firm spot in a muscle. When you press on it, it hurts — and sometimes the pain travels elsewhere. “Trigger” comes from English and means activator. The spot therefore triggers something. Trigger point therapy is not a tablet and not a drop. It is a treatment with the hands or with a fine needle. In treatment with the hands, someone presses, for example, with the thumb on the firm spot. In treatment with a needle, a very thin needle is inserted into the spot without anything being injected. This is called dry needling. Sometimes a liquid is also injected. This is done by doctors. Important: the trigger point sits in the muscle, not in the skin. That is why it must first be found. This is not so easy, because muscles feel similar from the outside. One study looked at how accurately such a firm spot in the shoulder-neck muscle can be found. This is important for treatment: only when the spot is found can it be treated.

2. Where Does It Come From?

Experts suspect that such a firm spot develops when a muscle remains tense for a long time. You may know this: you sit bent over homework for a long time, or you carry a heavy school bag. Then some muscles in the neck and shoulders remain tense for a long time. Also, if you perform a movement very often and one-sidedly during sport, a muscle can become tired. Researchers do not yet know this for certain. They continue to investigate why some people develop such spots and others do not. Some people do not feel such a spot at all, others clearly. It is more like a spot in the muscle that makes itself known.

3. What Are the Researchers Investigating?

There are very many works on this topic: 908 in total. In 623 of them, humans were involved. And 200 of them were controlled studies. Controlled means: one group receives the treatment, another group does not receive it or receives something else. Afterwards, what happened is compared. This makes it easier to see whether the treatment really helped. The researchers, for example, investigated how dry needling works for pain in the upper part of the body. Other works compared an injection at the trigger point site for back pain. Still others looked at whether trigger points play a role in migraine and tension-type headache. What do the researchers already know? That trigger points really sit in the muscle and that they can be treated. What is still open: why does one treatment help better than the other? And how can the spot be found most reliably? These questions continue to be investigated.

4. An Experiment to Think About

Sit up straight once and place your hand on your shoulder. Do you feel how the muscle feels? Rather soft or rather firm? Now imagine you had to describe this spot so precisely that another person could find it with eyes closed. Not so easy, is it? That is exactly the difficulty with trigger point therapy: the spot must first be found. One more thought: do not press firmly on painful spots. Instead, observe how your shoulders change over the course of the day — after sitting, after running, after carrying. Your body signals, and you can learn to listen.

For adults and professionals: the detailed page on trigger point therapy.