What Are Trigger Points and How Are They Treated?

If you've ever had a tight, painful spot in a muscle that seems to refer pain to another area, you've experienced a trigger point. These "muscle knots" are remarkably common and responsible for a significant proportion of chronic musculoskeletal pain.

What Is a Trigger Point?

A trigger point is a hyperirritable spot within a skeletal muscle — a contraction knot that's stuck in a shortened state. First systematically described by Dr Janet Travell, trigger points are characterised by:

- A palpable nodule within a taut band of muscle - Tenderness when pressed - A "jump sign" — the client flinches on palpation - Referred pain — pain felt in a predictable pattern away from the point itself

For example, trigger points in the trapezius refer pain to the base of the skull (causing tension headaches), and trigger points in the gluteus medius refer to the lower back.

How Are They Treated?

Deep tissue massage: Sustained pressure into the trigger point, held for 30–90 seconds, releases the contraction knot. This can be done with thumbs, knuckles, or elbows.

Cupping: Dry cupping over trigger points is extremely effective. The negative pressure lifts and decompresses the knot in a way that compression alone cannot.

Combined approach: Cupping followed by deep tissue massage provides the most thorough trigger point release available in manual therapy.