Do Your Trigger Points Keep Coming Back?

Trigger points are taut palpable bands in or around muscles that can result in either local or referred pain.

Latent (“silent”) trigger points tend to accumulate over a lifetime and appear to be the main cause of stiff joints and restricted range of motion.

Active trigger points can cause: headaches, neck and jaw pain, low back pain, symptoms of carpal tunnel syndrome, and many kinds of joint pain mistakenly ascribed to arthritis, tendinitis, bursitis or ligament injury.

Trigger points can cause problems as diverse as: earaches, dizziness, nausea, heartburn, chest pain, heart palpitations, tennis elbow, tinnitus and genital pain.

Because trigger points can be responsible for chronic pain and disability, they can also cause depression and anxiety.

Causes of myofascial pain syndromes include macro trauma, such as a strain/sprain injury or car accident. They can also include repetitive micro traumas, such as those caused by typing or other repetitive fine motor movements.

There are numerous perpetuating factors that also play a role in the development or maintenance of trigger points. These include:

  1. Mechanical factors
  2. Nutritional inadequacies
  3. Dietary factors
  4. Metabolic and endocrine imbalance
  5. Psychological factors
  6. Other factors


Mechanical factors

Congenital irregularities in bone structure, postural stress, poor work habits, repetitive strain, trauma and poor conditioning can all contribute to abnormal muscle stresses and consequently the formation and maintenance of trigger points.


Nutritional inadequacies

Many  people seen with trigger points are lacking in certain vitamins and/or minerals that are necessary for proper muscle function and metabolism. Some of these include: Vitamins B1, B6, B12, folic acid, vitamin C and the minerals calcium, iron, magnesium and potassium.


Dietary factors

Diets high in alcohol, caffeine, sugar and processed foods can cause irregularity in one’s metabolism, making it difficult to keep trigger points deactivated.


Metabolic and Endocrine imbalances

Chemical or glandular imbalance can interfere with metabolism in muscles thereby affecting trigger points e.g. Thyroid inadequacy, hypoglycemia, anemia, estrogen/progesterone imbalances and high levels of uric acid.


Psychological factors

Anxiety, depression and daily nervousness can cause constant muscles tension, thereby perpetuating trigger points. People who are anxious often have shallow breathing, which causes some of the neck muscles to tighten and become plagued with trigger points.


Other factors

Sedentary lifestyle, lack of exercise, poor sleep habits and chronic diseases can all affect muscles, by causing stiffness and weakness.


Treatment considerations

Trigger points respond to a number of therapies, some of which include:

  • Dry needling
  • Pressure
  • Pin and stretch
  • Foam rolling


In acute cases, trigger points often respond rapidly and don’t recur. Chronic trigger points often have one or more perpetuating factors that need to be addressed.


If you have recurrent trigger points, take another look at this list. You could have one or more  perpetuating factors:

  1. Mechanical factors  (Muscle imbalances, joint dysfunction, repetitive overuse)
  2. Nutritional inadequacies and Dietary factors (A diet high in refined foods and/or lacking adequate nutrients. Also keep in mind that many medications can affect nutritional status)
  3. Metabolic and endocrine imbalance (Undetected thyroid problem, hormonal imbalance, anemia)
  4. Psychological factors  (High stress, anxiety, depression)
  5. Other factors (e.g. Chronic illness)




Dommerholt, J., Bron, C., & Franssen, J. (2006). Myofascial trigger points: an evidence-informed review. Journal of Manual & Manipulative Therapy, 14(4), 203-221.


Travell, J. G., & Simons, D. G. (1992). Myofascial pain and dysfunction: the trigger point manual (Vol. 2). Lippincott Williams & Wilkins.

About the Author

Dr. Geoff LecovinNaturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/View all posts by Dr. Geoff Lecovin