How to Use This Membership Website

 

This is not a quick fix! There is no such thing as resolving your pain in 15 minutes or less in five easy steps with any technique. Ideally you will be working in conjunction with a therapist trained in trigger point or neuromuscular therapy, who can assign muscles for self-help. If not, this will take some detective work on your part as you look through the muscle chapters, search for trigger points in your muscles, and use the self-help techniques on a regular basis until your pain is resolved. It is an excellent method for treating pain of muscular origin, but it will take some of your time. Ask yourself: is it worth some of my time to resolve my pain? If the answer is yes, then you will find the information on this Membership Website very helpful.

It is important that you don’t make assumptions about the cause of your symptoms, especially if the pain is severe. You may need to see a health care provider to rule out herniated disks, organ dysfunction, cancer, disc fractures, urinary tract infections, gallstones, liver disease, abdominal infections, an aortic aneurysm, multiple sclerosis, diverticulitis, myasthenia gravis,¹ or other serious conditions before attempting self-application of trigger point therapy, particularly on the back or neck. If you have already ruled out serious causes, and especially if physicians and other diagnostic techniques have not come up with an explanation for your symptoms, you may very well find relief with trigger point therapy.

 

Body Pain Map

To use the body pain map, find the area where you feel pain. Look for the corresponding list of muscles that might harbor trigger points that are causing your problems.  You will need to read all of the listed chapters.

Look at the pictures of trigger point referral patterns in the chapters, and try working on the muscles to see if you can get relief. You may need to work on all the listed muscles if you are not sure which muscle contains the trigger points that are causing your pain.  Trigger points in more than one muscle may be causing your pain. The muscles are listed in order from top to bottom of the most common muscles to refer pain to an area, but it may be different for you, so be sure to read all of the chapters.

Photos with Referral Patterns

On the pain referral photos, the more solid red area shows the common “primary” area of referral, which is almost always present, and the more lightly red-stippled area shows the common “secondary” area of referral, which may or may not be present. An “X” marks the spot where trigger points are commonly found in conjunction with that referral pattern. There may be additional trigger points, so search the entire muscle.

The pictures in the muscle chapters only show the most common referral patterns, but you also need to consider that your referral pattern may be anywhere from somewhat different to completely different. Overlapping referral patterns from trigger points in multiple muscles may be more painful and cause a pattern that is larger than the individual muscle common patterns, so be sure to search for trigger points in all the muscles that refer pain to that area.

If you only get temporary relief, start looking for muscles that refer to that area of the muscle that you have found contains trigger points. The trigger points that give you temporary relief when worked on are called satellite trigger points, and the trigger points that keep re-activating them are called primary trigger points. For example, if you have lower jaw pain and you can get temporary relief from working on the masseter, consider whether referral from trigger points in the upper portion of the trapezius muscle are keeping the masseter trigger points active. In this case the masseter muscle contains the satellite trigger points, and the trapezius muscle contains the primary trigger points. Each muscle chapter contains a list of other possible muscles that may be involved under “Also See:,” but because everyone’s body is so different, you may need to look through the chapters at the referral patterns and consider whether additional muscles may be involved in your case.

I occasionally see something I call “reverse referral,” where what is normally the area of referral contains trigger points that refer to where the trigger points would usually be. An example would be trigger points in the gluteal area referring to the lumbar area of the back, when normally lumbar trigger points would refer to the gluteal area. So you may also need to check referral areas too, opposite of what the picture indicates. This is one of the situations where working with a trained practitioner would be especially helpful.

You may wish to print off and copy the blank body chart and draw your symptom pattern on it, and then use it to compare with the pictures in the chapters. I also recommend that you fill out a body chart at least a couple of times per week. It will come in handy in several ways: it will be easier to discern which patterns fit your pain referral most closely; it will help you recognize the factors that cause and keep your symptoms active; you will be able to track your progress (or lack thereof); and you will have a historical record of past injuries. As your condition improves, you will forget how intense it was originally. This can lead to frustration if you think you are not getting better. If there is a reduction in the overall intensity, frequency, and/or amount of area affected, you are improving, even if at times it gets worse again. One note: not everyone can accurately draw their pain location, in part due to lack of familiarity with anatomy, so take that possibility into consideration and check muscles with nearby referral patterns just in case your drawing is inaccurate.

Muscle Chapters

The blue letters are links.

Each muscle section contains a list of common symptoms and common causes of trigger point activation and perpetuation. Again, these are only the most common, and there may be other symptoms and causes for you. Try to imagine, for example, if an activity you do would be similar to something on the list, in effect causing the same type of stress on the muscle.

Each section has stretches and exercises that are appropriate for that specific muscle. Have your practitioner check to make sure you are performing them properly and not causing additional stress to the muscle. If your symptoms are worsening, stop doing the self-help techniques and check with your practitioner.

Search Feature

Trigger points can cause symptoms not usually thought of as being of muscular origin, such as dizziness, urinary frequency, vaginal burning, hearing problems, blurred vision, and many more. Check the search feature located at the bottom of each page (footer) for your symptoms to see if it is possible trigger points in muscles could be the cause.  Try searching for both “lay” and medical terms, for example, search on both “tinnitus” and “ringing” to make sure you get all the pertinent results.

I do not recommend using the search feature to type in an area of pain, for example, foot pain. Since there are numerous zones of painful areas on the foot, you will end up with a very long list of muscles that refer pain to the foot. If you use the body pain map on the home page and narrow down the affected area of the foot, you will get a much shorter list of muscle chapters that you will need to look at.

General Suggestions

Set realistic goals. Focus on a few areas at a time to work on, unless it is imperative that you work on several together. Setting unrealistic goals which results in you being unable to do all the self-help techniques can lead to discouragement and giving up. It is better to pick a few things and do them well rather than to rush through several self-help techniques and/or suggestions and do them poorly. You probably won’t be able to apply pressure on and do stretches for five muscles, learn proper breathing and posture, replace all your furniture at work, overhaul your diet, and start walking every day all in the first week. Pace yourself so that this is an enjoyable process and you are working on the perpetuating factors over time. If you are working with a practitioner, they should be able to help you prioritize what needs to be done in the order of most importance. If they are giving you too many things to do at once, be sure to tell them that you are overwhelmed and need to set priorities (giving a patient too many assignments is all too easy for a practitioner to do when they are first out of school and brimming with many useful ideas and suggestions). There are hundreds of suggestions on this CD. Read through the entire perpetuating factors chapter and the helpful hints in the muscle chapters applicable to your pain referral patterns. Make a few notes, or if you print pages off, highlight the ones you think are pertinent to your situation. Then plan to take some time to accomplish your set goals.

With best wishes for your improved health,

Valerie DeLaune, LAc

1. Janet G. Travell , M.D., and David G. Simons, M.D., Myofascial Pain and Dysfunction: The Trigger Point Manual, vol. I, The Upper Extremities, (Baltimore: Williams & Wilkins, 1983), pp. 39-40.