Hint: It has nothing to do with a gun.

A trigger point usually consists of a small band of muscle which feels knotty. It is sometimes painful when touched, but the pain is often referred to another area of the body. A trigger point in the shoulder, for example, might cause a headache.

What causes a trigger point? Acute trauma or repetitive micro-trauma may lead to the development of stress on muscle fibers and the formation of trigger points. Trigger points are thought to be due to an accumulation within deep muscle of the waste products of physical activity. This causes localized muscle tension and spasm which may make the points feel like small nodules.

Patients may have regional, persistent pain resulting in a decreased range of motion in the affected muscles. These include muscles used to maintain body posture, such as those in the neck, shoulders, hip and pelvic girdle.

Trigger points may manifest as tension headache, jaw pain (TMJ), tinnitus (ringing in the ear), decreased range of motion in the legs, low back and neck pain. Trigger points have also been found to be related to shoulder pain, carpal tunnel, sciatica, hip/knee pain and foot/ankle pain. Usually, a physical therapist will ‘feel-out’ a hypersensitive bundle, or knot, of muscle fiber associated with a trigger point. Hands-on pressure of the trigger point will elicit pain directly over the affected area and/or cause radiation of pain toward a zone of reference and a local twitch response.

Physical therapy has been shown to be one of the most effective treatments to inactivate trigger points and provide prompt relief of symptoms. Physical therapy treatment, such as the strain/counter-strain technique, ischemic compression, cupping, massage, myofascial release, active release techniques, electrical stimulation, ultrasound, joint mobilization therapy and corrective exercises, are used to ease the tension, numbness and pain associated with trigger points.

The key to success with trigger point symptoms is to be consistent with therapy and to know what caused the tightness in the first place so that you can avoid it in the future.