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What are trigger points? | Dr. Michael Sein | Weill Cornell Medicine

What are trigger points? | Dr. Michael Sein | Weill Cornell Medicine

I’m Dr. Michael Sein assistant professor
of rehabilitation at Weill Cornell Medicine today we’re at the Center for
comprehensive spine care and I’d like to talk to you about muscle nuts this is a
painful condition that many of us develop often called myofascial trigger
points by physicians when this has been chronic we call it myofascial pain We believe that muscle knots are
actually small areas of hyper tense muscle that don’t get enough blood flow
thus don’t flush enough toxins away leading to inflammation and pain they
are most common in the trapezius muscle muscles around the shoulder blade and
along the spine called paraspinal muscles these trigger points may feel
hard or swollen they may take sting or stab discomfort usually increases when
pressure is applied and they can make it hard to find a comfortable sleep
position wake you up from sleep or decrease your range of motion knots may
develop from overworking muscles for a long period of time from repetitive
movements or from poor posture everyday activities such as prolonged work on the
computer talking on the phone or driving our examples stress also plays a role
diagnosis requires a physical exam with a doctor may gently press on the painful
region to locate tense areas pressing on them in a certain way may cause a
response in the muscles such as at which muscle knots can also cause pain in
other parts of the body which we call referred pain pain can be referred
because signals from several areas of the body often travel through the same
nerve pathways to reach the spinal cord and brain an extreme example of this is
patient suffering a heart attack may feel pain in their left shoulder the
heart is a muscle and it can signal to nerves in other parts of the body that
there’s an issue similarly some patients with trigger points in their shoulders
experience referred pain in the back of the head or temple leading to headaches
although muscle knots can cause a lot of discomfort they often respond well to
conservative treatments this includes stretching strengthening and
cardiovascular exercise your doctor may recommend physical
therapy physical therapist can work on posture they can also work on sleep
positions to avoid tension and they can also give you some pointers on how to
make your workstation ergonomic another treatment is deep tissue massage which
can work to break up painful muscle knots and release stress self massage
can also bring relief I tell my patients to massage sore areas either with their
hands or the small firm ball or a foam roller well it’s not clear exactly how
it works acupuncture can be an effective
complementary treatment sometimes doctors may prescribe anti-inflammatory
drugs like ibuprofen or muscle relaxants for short period of time to reduce
discomfort in more persistent cases doctors may consider trigger point
injection during this procedure the doctor injects the muscle trigger point
with a local anesthetic or saline solution regardless of which is use the
mechanical action the needle and fluid injected is the same the injection
breaks up the knots and flushes away surrounding inflammation allowing for
improved circulation I utilizes treatment to reduce pain so that my
patients can maximize their exercise stretching and effects of physical
therapy once you recover continue to follow a program of stretching
strengthening and cardiovascular exercise to keep myofascial pain from
returning and avoid new muscle knots I’m doctor Michael Sein thank you for

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