A myofascial trigger point is a hyperirritable spot within a taut band of skeletal muscle. When you press on it, it hurts locally and often refers pain to a predictable distant location. Trigger points are one of the most common — and most missed — causes of musculoskeletal pain.
What's actually happening at the tissue level
Current thinking is that a trigger point represents a small region where muscle fibres are locked in a shortened state. Reduced local circulation creates an energy crisis in those fibres, and a self-sustaining loop of pain and dysfunction develops. The taut band you can palpate is the physical evidence of this.
Common referral patterns
- Upper trap trigger points refer to the temple — a common headache generator
- Suboccipital triggers refer to the back and top of the head
- Infraspinatus (rotator cuff) triggers refer deep into the front of the shoulder — mimicking rotator cuff pathology
- Gluteus medius triggers refer down the outside of the thigh — mimicking IT band pain
- Piriformis triggers refer down the back of the leg — mimicking sciatica
- QL triggers refer to the SI joint region — mimicking SI pain
This is why identifying the actual pain generator matters. Treating the site of pain without checking the referring muscle often fails.
Why massage alone often doesn't hold
Pressure and stretching can temporarily quiet a trigger point, but the underlying dysfunction often re-establishes within days if the driving factors aren't addressed. Chronic trigger points usually have upstream drivers — postural, mechanical, or emotional stress patterns.
Why dry needling works
Dry needling uses a thin filament needle inserted directly into the trigger point. The mechanism involves:
- A local twitch response that disrupts the sustained contraction
- Increased local blood flow after the needle is removed
- Modulation of pain-processing pathways in the spinal cord and brain
Patients often report significant relief within a session or two — sometimes lasting weeks, especially when combined with corrective exercise and postural work.
How we use it
Dry needling is one tool in a broader treatment plan. We combine it with soft tissue therapy, joint mobilization, corrective exercise, and lifestyle changes that address why the trigger points formed in the first place. Isolated dry needling without the rest of the plan is often short-lived.
If chronic tightness, headaches, or "knots" have been persistent, come in for an assessment. Trigger point mapping is one of the most useful things we do.