Trigger Points & Fascia Pain

A trigger point is a small, tight, tender knot inside a taut band of muscle. Pressing it causes pain at that spot and pain spreading to another area (referred pain).

Myofascial pain syndrome is ongoing pain from trigger points and the surrounding fascia. Common causes: poor posture, overuse, stress and poor sleep.

Related anatomy — the fascia

• Fascia is a thin sheet of connective tissue that wraps around muscles, like cling film.
• It allows muscles to slide smoothly against each other.
• Fascia has many nerve endings, so it can be a source of pain.
• Tight or “stuck” fascia limits movement and causes stiffness.

Common regions affected

• Upper trapezius — neck pain and tension headache
• Levator scapulae — stiff neck
• Rhomboids — pain between the shoulder blades
• Infraspinatus — shoulder pain
• Quadratus lumborum — low back pain
• Gluteus medius and piriformis — buttock pain that can mimic sciatica
• Calf — cramps and tightness
• Plantar fascia — heel pain

Management plan

• Find and fix the cause: posture, desk setup, stress, sleep.
• Regular stretching and strengthening.
• Self-massage with a foam roller or massage ball.
• Heat therapy.
• Manual therapy and myofascial release by a physiotherapist.
• Dry needling or trigger point injection.
• Ultrasound-guided hydrodissection for stubborn fascia pain.
• Short-term painkillers when needed.