Trigger Point
Symptoms & Causes

Some of the symptoms that can be caused by active trigger points

Arrhythmia, Arm Pain, Bladder Control (includes frequency, urgency, leakage and nocturia), Bowel Symptoms (including IBS), Carpal Tunnel Syndrome, Costochondritis, Diarrhea (chronic), Dry Cough (chronic), Erectile Dysfunction (ED), Fibromyalgia, Frozen Shoulder, Genital Pain, Headache (includes cluster and cervicogenic headaches), Heartburn/GERD, Intercourse (painful), Joint Pain (e.g. arthritis), Levator Ani Syndrome, Lower Back Pain, Migraine, Menstruation Pain (i.e. dysmenorrhea), Pelvic Floor Dysfunction, Plantar Fasciitis, Prostatitis (diagnosed), Rectal Pain, Sciatica, Shin Splints, Shoulder Joint Symptoms, TMJ Dysfunction, Testicular Pain, Thoracic Outlet Syndrome (TOS), Tennis Elbow, Vertigo/Dizziness.


Causes of trigger point formation

Emotional stress will always play a role in muscle function. The trapezius and quadratus lumborum is most susceptible to the effects of emotional stress, although many other muscles can be affected by stress. Tension, anxiety and everyday nervousness can make trigger point therapy ineffective. Habitually holding your muscles tight never gives them a chance to rest, not even at night when you’re sleeping. (Davies: 2001, 30)

Sedentary lifestyle will provide a prime environment for trigger points to establish themselves.

Metabolic disorders can make it difficult to get rid of trigger points. Some conditions that can interfere with treatment efficacy are thyroid inadequacy, hypoglycemia, anaemia, and high levels of uric acid in the blood (uricemia). Nicotine, caffeine and alcohol cause enough irregularity in the metabolism to make it difficult to keep trigger points deactivated. (1999: 213-220)

Excessive overworking of muscles can lead to trigger point related issues. People who are new to the fitness routine can easily over-stress their muscles to the point of causing TrPs to form. As well, experienced athletes who continually workout can suddenly experience trigger point related problems. We usually see this as knee issues, shoulder problems, shin splints, groin ache and so on. Musicians are very susceptible to TrPs forming in those muscles that are continually used during practice.

Physical trauma may also cause trigger points to form in muscle tissue. Physical trauma can be anything from a whiplash injury, a sport related accident, or a surgical procedure where muscle is cut.

Diet deficiencies* in key vitamins/minerals can lead to improper contraction/relaxation of muscle tissue. We need an adequate amount of B’s, C, Calcium, Magnesium, Potassium, Folic Acid and Iron, for healthy muscle functions.

Skeletal abnormalities will place a constant strain on related muscles. Consequently, these folks will most likely always be prone to trigger points forming. Some examples of skeletal abnormalities are Morton foot structure, lower limb length inequality (LLLI), asymmetric pelvis, and short upper arms.

Relevance to trigger point treatments: Many symptoms that seem to baffle medical professionals have a myofascial (muscular) source.


* long-term use of some medications, such as proton pump inhibitors, can interfere with the absorption of key vitamins and minerals.

Muscle is an orphan organ. No medical specialty claims it. As a consequence, no medical specialty is concerned with promoting funded research into muscular causes of pain, and medical students and physical therapists rarely receive adequate primary training in how to recognize and treat myofascial trigger points.

Dr. David G. Simons M.D.
Co-author: Travell and Simons;
Myofascial Pain and Dysfunction, The Trigger Point Manual

A Story of Inspiration

I ended up in Bill’s office after 3 1/2 years of daily pain – worn out emotionally, physically, and somewhat financially from all the different modalities I had tried. Finally I was willing to “surrender” and do what he told me to do – I stopped working-out (which I love,... Read more
Susan L.
Nanaimo, BC