Trigger points...?

Has anyone had their trigger points checked? Apparently, if muscle tension in the neck/shoulder area is a cause of headaches, certain kinds of trigger-point manipulation (massage, saline injection, etc.) can relieve the symptoms.

I'm asking because, for one thing, I read a post somewhere else about checking trigger points on your own. I noticed by pressing an area around the shoulder blades, the pressure in my head became instantly worse, and it also brought on a low-intensity headache. I don't know if this is meaningful or not, but perhaps it's another avenue worth looking at. Also, today, my psychiatrist said that neurologists can check trigger points.

Really, I don't know enough about this, or how to treat problems with trigger points. But apparently they can be a cause of chronic headaches for some people. Perhaps someone here has some ideas?

Hoping to hear back,
Batman55

I have chronic daily headaches and a physical therapist, who worked on the neck and shoulders and did lower the pain level for me. I then went (and still go) to a neuromuscular (trigger point) therapist who worked on the entire body to address skeletal/muscular imbalances. She did lower the headache pain levels a bit more. And I went and am still going (every so often) to a somatic practitioner, who gave me some exercises (to do daily) which allows me to maintain the progress I have made on my tight muscles. I still get headaches of varying pain intensity, but the overall pain level is lower. I also use baclofen, a muscle relaxant, to keep the muscles from tightening up.

Here is a website that addresses headache pain trigger points:

http://www.round-earth.com/HeadPainIntro.html

A regular massage therapist did nothing for me, but cause me a great deal of pain. Trigger point therapy is a long drawn out process.

Martin

I had some so called trigger point injections done by a neuro in addition to trying an occipital nerve block done by an anesthesiologist. That was way before my current fibro and auto immune issues, for which I do have many trigger points, joint & muscle problems, widespread pain, etc. Massage in a myofascial release style helps, but I can't get the actual points worked on directly as its was too painful. I have some spots at some times it hurts to press on my skin, let alone get a massage. I think they can be a contributing cause to migraines, but not sudden onset 24/7 type headaches (which is what I have and most of my knowledge is in). I think almost everyone's headache has a neck muscle cause/effect relationship to some extent. Some people are helped more than others for treatments geared towards that like muscle relaxers, pt, chiro, massage, injections, etc. I've tried it all with unfortunately little success. I do believe everyone should give a fair shot to every treatment within reason that they can afford, starting with of course the cheaper, easier, less risky ones. Everyone really is that different. The term trigger points can actually have several meanings. Best wishes.

I appreciate the advice. But I must admit I have a lot of difficulty "taking charge" of things and using the information gained here in a beneficial way. I still don't have an answer to this question: if I was to get trigger points looked at or manipulated in some way, who should I ask, where should I go?

On another forum, the response was to ask my neurologist to "check the trigger points." But then I am uncertain if my doctor is open to taking requests from patients; not to mention, the next appointment is in mid September.

If not the neuro, who else can provide some "help" in these areas? I have no knowledge of massage clinics and do not know of any physical therapists, personally.

I really could use some advice here...

Batman, the issue of trigger points seems to be more complex, so perhaps you need to read and research it more to see if it might be useful to consider any treatments.

I have in the past been told that there is a way of treating tgrigger points by acupuncture, but I was not convinced at the time, since previous acupuncture treatemnt brought poor results.

There was also some person offering electrical impulse stimulation to trigger points, which I have also rejected, as I do not believe in any such "fast fixes" which alwasy involve lots of extra hard cash payments.

Still maybe you can start with this article, which is a serious paper on the subject:

http://www.medicalacupuncture.org/aama_marf/journal/vol17_3/article_3.html

since it has some very useful illustration of trigger points and where they are, and also explains the "mechanics" of refered pain involved.

Also have a look at Wikipedia for a simple explanation of the term: trigger points.

I think the best person to show you where any specific traigger points are on your body, would be your neurologist since they know anatomically where to look for them.
So, ask can your neurlogist during you next visit to show you where your trigger points are, and once s/he does, you can also ask if there are any way that treating of strimulating them in order to ease your head pain.

I cannot see how any neuroligist could object to that. Do you?

Another way to broach any subject with a doctor is just an open ended "I read about X and am interested in the topic as it could relate to my condition", "Do you think any alternative treatments like chiro, physical therapy, etc, would be helpful to me?". What do you have to say on the subject? A lot better than saying "I think I have X" or "should be prescribed X?" lol. I do think these sorts of questions are for later visits than the first couple though, and probably max of 1 or 2 of these sorts of thing per visit, and probably not every visit. If your doctor isn't having new ideas each visit and seeing you often (every 1-3 month) while you are unstable, honestly, I would ditch them and try to find a better one (go to new doctors before officially telling them you won't see them anymore). I don't ever mention conditions or medications by name unless my doctor says they are stumped, but usually by then its time for a referral. A doctor should be able to suggest a particular practitioner if the treatment is appropriate for you, but I have found these places on my own before since my insurance doesn't require referrals (online reviews, but typically I choose places based on location & hours of business that have websites lol). Best wishes.

tortoisegirl wrote:...I think they can be a contributing cause to migraines, but not sudden onset 24/7 type headaches (which is what I have and most of my knowledge is in)...

I wanted to comment on this the other day, but forgot about it. In any event, in response to this point... how can you be so sure trigger point problems don't contribute to 24/7 headaches?

I tried someone's advice about pressing the area around the shoulder blade, and--bingo--the head pressure I have is instantly worse, and a mild headache starts up. Despite the complexity of these things, I think that response is fairly conclusive in proving there's a strong musculo-skeletal component to my own case of 24/7 "head pressure." I would not be in any position to say it's causative, but contributing is almost a certainty. The interesting thing is, the sensation I get when pressing on this area is not just "vague pain" but it's actually identical to the core complaint that brings me here (pressure.) That has to count for something, y'know?

batman55, I agree with you, there are certain trigger points, that have an immediate piercing pain on the side of the head and a higher level of headache pain that lasts for weeks.
With me, if somebody tries to manipulate the left SCM or the levator scapulane muscles, I get the higher level headache pain. Another trigger point is the soft spot on the crown of my head.

My headache is also of the 24/7 type, of varying intensity. With the trigger point therapist, she never touches the above muscles, but only muscles that cause the tight left SCM and levator muscles.

Martin

Batman55 wrote:

tortoisegirl wrote:...I think they can be a contributing cause to migraines, but not sudden onset 24/7 type headaches (which is what I have and most of my knowledge is in)...

...From my experience and my doctors comments and reading the forums as far as people being "cured" from similar headaches (few), I don't see how trigger points can be a primary cause of a sudden onset headache...how does something go from nothing to severely something overnight when it muscular? Neuro makes more since (some switch in the brain being flipped to generate pain). With muscular, I'd guess you'd see pain build up over time. More similar to how chronic daily migraine would develop...more and more migraines over time until they are daily. Its my opinion though. I'd love to know of proof otherwise (thus I led it with "I think", not "I know"). I look forward to reading if you pursue this. Best wishes.