arrow11 Comments
  1. philippa shatford
    Jul 16 - 6:53 pm

    Dear Philida Bunkle,I am so pleased to see something written by New Zealand.
    I am an ex nurse and did a dip in massage 1990s
    So now I reap the consequences of having lead a busy life with the inevitable losses etc.
    I use the PatientsLikeMe website And out of thousands of FM sufferers I find myself in comparrison, able to live a limited but satisfying life.
    I have visited the local christchurch support group for FM but found a group of friendly elderly ladies who seemed into pills and specialists and having more worldly wealth than me! An impression only.
    So I get along with swim pool,acupuncture,Helios Medical centre for supplements and minimal
    meds,and some hobbies and interests.
    But people do seem to recover and I am curious.Perhaps one needs lots of money to buy things or is it knowing the right people who have found recovery?for inspiration?
    I have got most info from US A even if they seem to me to be drug orientated.
    It seems medical care and attitudes vary enormusly from country to country, Dr.,person to person but the internett becomes the melting pot for all facts and experiences.
    Thankyou Philida for your writing and info.
    Sincerely,Philippa S.

  2. @roedemeis1
    Jul 16 - 6:54 pm

    Excellent information that is clearly explained.

    My understanding of how to get the blood flow through these points has definitely improved my understanding of exactly what trigger points are, how the blood flow through or blocked in them, causes the pains that I as a patient suffer.

    It makes sense to anchor the fascia gently as you unblock the tender point you are manipulating. This was a new technique that your essay made me aware of.

    It is understandable that anchoring ( applying tension lightly in the opposite way of the direction an area is going to be manipulated), is used in other treatments such as drawing blood, or starting an IV, and techniques that doctors learn.

    It must be a physical law.

    Thank you very much for writing this helpful information.

    • Tricia Watkins
      Jul 17 - 2:57 am

      I hope you will forgive me for bringing to your attention the fact that this article did not recommend combining trigger point therapy and myofascial release, the latter considered to be a treatment in itself. According to Travell and Simons, myofascial release has limited effect in the treatment of trigger points and I believe it is a treatment which does not get to the source of the problem. Symptoms may be temporarily relieved but are usually not long lasting. Trigger points start in the muscles, spread to the fascia and then to the skin, resulting in allodynia. Getting to the source and deactivating the trigger points will result in the fascia and skin reverting to normal. I have had this experience myself. However, deactivating trigger points is not enough if all the perpetuating factors are not addressed and there is a long list of them. I also would not recommend Phillida’s mode of therapy as it is very painful and very few people would stick to it. I have used the stroking method for the last 17 years and I find it to be very effective with minimal aversion. There is a myth though that trigger point therapy will always give you instant relief and the trigger points can be released quickly and easily. OK if it is a new pain but if it is a longstanding problem, stirring up the trigger points can make it worse for a while before it gets better ( we all know the old saying). From my own experience also, the trigger points can appear asymptomatic but when you find one (and it is not nice – it is so painful it makes you jump which is why Travell and Simons called it the jump sign), working on it does not immediately illicit the referred pain pattern. This may happen up to 5 -10 minutes later ( our nerve conduction appears to be slower). I find Clair Davies book to be excellent as it gives just enough information for lay people to apply themselves to their own trigger point therapy and find a lot of success. I use a theracane and a tennis ball or lacrosse ball in a sock so you don’t lose it. Phillida mentions the work of professional therapists in stretching the trigger points out of muscles but fails to mention that the skin must be anaesthetised in order for this to be effective ( this is known as spray and stretch).

      • Linda Horncastle
        Sep 05 - 10:20 am

        Tricia, I agree with your comments.
        I have FM and myofascial syndrome as well as the above I find the microcurrent device called the Alpha-Stim helps in a gentle way of releasing trigger points.
        Also using a ball and rubbing against a wall to release trigger points in the shoulders and back and lying on the floor to release Gluteus maximus. My favourite ball is a softer dog ball. posture is also essential to help stop the perpetuating factors.
        The book I prefer is ‘Healing through trigger point therapy’ by Starlanyl and Sharkey. A little more detail than the others mentioned.

  3. Ria Roegiers
    Jul 17 - 1:58 am

    I’m Belgian and myofascia therapy is called just fascia therapy here. It is an ‘art’ that has to be performed by a skilled fysiotherapist. It helped me greatly and I experienced it to be much more than a mere physical therapy, it helped on an emotional and even spiritual level as well (this was also because the therapist was very, very good).
    Then I took up qigong and I stopped going but I do recommend this highly.
    Thanks for the book references.

  4. David Katcoff
    Jul 17 - 6:59 am

    Some of us with ME/CFS mainly have the neurological symptoms, such as pressure headaches, mental fog, fatigue and sometimes light sensitivity and cardiac arrhythmia. I try to exercise daily, so maybe that’s one reason I don’t have much muscle pain.
    I was just reading about the symptoms of concussion and the similarities in some areas are striking. One difference is that the ME/CFS symptoms vary a lot, even in the course of a day.

  5. Evan
    Jul 18 - 7:42 am

    Another excellent technique is instead of using a dry needle or one with a saline/ribose solution, is to inject your own platelet rich plasma directly into the trigger point. “PRP” injections as they are called puts the nutrients most needed directly into the damaged soft tissue!

  6. Greg Burge
    Jul 19 - 1:49 pm

    Hello everyone,

    I had the exceptional good fortune to be the patient of a neurologist who specialized in trigger point therapy for 12 years – Dr. Robert Gerwin. Unfortunately for his patients he retired at the end of 2013 leaving a huge gap in local medical knowledge on what remains an arcane subject. Dr. Gerwin was 75 last year so his retirement was certainly due, he did tell me that there was no other neurologist in the area practicing trigger point therapy so he was unable to make a referral.

    Philida Bunkle’s article gives a short synopsis of several conditions and therapies that are otherwise very poorly understood and/or described in most of the commentary I have seen on the Internet. Trigger points, tender points, pressure point therapy, myofascial release, dry needling, injection therapy etc,etc.

    I would recommend anyone interested in trigger point self therapy to get Clair Davies’ manual which is inexpensive (less < $20 from Amazon) clear and easy to follow. If possible get the first edition of Davies' book – the later editions just add extraneous information. A theracane and a small hard ball are also needed. I use a super ball as I find tennis balls too soft.

    Dr. Gerwin described trigger points as adhesions in a band of muscle that would prevent that muscle from relaxing, resulting in a taught band of muscle. The trigger point can be identified as a knot or lump usually near the center of the taught muscle. Pressing on this knot is highly painful.

    Trigger points can vary from painful and annoying to crippling in their effect. Anyone can get them from injuries due to sports or accidents but some of us with ME have some chronic problems. I manage most of my trigger points through self help with a theracane and a ball in a sock but for some severe ones professional intervention is required. For some reason when a needle is inserted into a trigger point it will cause the adhesion to release, which also manifests as a strong twitch in the muscle and considerable pain. The pain is short and the relief is long lasting.

    Personally I have been cured from radiculitis (compressed nerve root at the spine), TMJ and a severe problem with my piriformis in one leg that was crippling, by needling, as well as several less sever problems.

    After treating a trigger point it is best to apply moist heat for about 1/2 hour and follow with ice thereafter, heat to relax the muscle and ice to ameliorate inflammation. For self help this is not usually necessary.

    A lot of suffering can be avoided through trigger point therapy. I recommend it highly to anyone who has chronic muscle pain. Just useful for actual trigger points though..

    I hope this is useful and wish you all the best

  7. Joyce Johnston
    Jul 24 - 12:38 pm

    I went to a Neurosurgeon at Northwestern Memorial Hosp. in IL about 6 yrs. ago. He had me see a physiatrist, a doctor who doe non-surgical spine and musculoskeletal care for myalgia of the neck & back & migraines. She gives me novacaine shots in those trigger point areas which help a lot. Massages were also recommended & PT. I have been using the
    theracane, balls in socks & waded-up socks for years. Helps tremendously except now my hand are going (very hard to use theracane now which was my lifesaver. In the massages as with the rest you have to find the referred pain also. I was told by PT if you try to relieve the round knots or swollen glands in your necks in circular motion you bruise the tissue. They recommend long straight strokes down that will touch over the bumps so you get even tension & don’t bruise the tissue. I use the “Trigger Point Therapy Workbook” by Davies & Davies as a reference. It is a good manual for trigger points for your whole body.

    It seems like we are all doing pretty much the same thing. Hopefully more relief will come along soon!

    • Rebecca
      Jul 28 - 9:22 pm

      I went to Northwestern Memorial Hospital, recently. I was told to go to the pain management center. There, they work with all sorts of methods.

      However, the doctor would not allow me to enter the program because I have fibro./me and I am too exhausted to exercise. He would not prescribe anything for pain because he said it would make me tired.

      Well, I am already tired and in pain. I’ve been this way for 20 years. Can you tell me who was the doctor you saw or suggest another place at Northwestern Memorial? It is one of the best hospitals around.

      • Linda Horncastle
        Sep 05 - 10:26 am

        Hi Rebecca,
        I suggest try and find a doctor or therapist in your area using the Alpha-stim (microcurrent therapy). It is a very gentle way of releasing trigger points. Also if you use the ear-clips for a while you should see an improvement in sleep and therefore more energy to cope with exercise.

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