Myofascial Pain Syndrome: How Trigger Points Cause Pain and How to Release Them

Myofascial Pain Syndrome: How Trigger Points Cause Pain and How to Release Them Dec, 30 2025

Chronic muscle pain that won’t go away-even after rest, ice, or painkillers-might not be a strain, a pinched nerve, or arthritis. It could be myofascial pain syndrome (MPS), a condition hiding in plain sight. Millions of people live with it, often misdiagnosed for years. The real culprit? Tight knots in your muscles called trigger points. These aren’t just sore spots. They’re active pain generators that send discomfort shooting into your neck, shoulder, head, or even down your arm-mimicking other conditions like sciatica or carpal tunnel. The good news? You don’t need surgery or strong drugs to find relief. Understanding how trigger points work and how to release them can change everything.

What Exactly Are Trigger Points?

Trigger points are tiny, hyperirritable spots inside a taut band of muscle. Think of them like a cramp that never unwinds. They’re usually 2 to 10 millimeters across-small enough to miss on an MRI, but big enough to cause major pain. When you press on one, you might feel a sharp ache right where you’re touching. But here’s the twist: the pain often travels. A trigger point in your upper trapezius (the muscle that runs from your neck to your shoulder) can make your temple throb. One in your jaw muscle can feel like a toothache. That’s why so many people end up seeing dentists, neurologists, or orthopedists before anyone checks their muscles.

There are two types: active and latent. Active trigger points hurt even when you’re not touching them. They’re the ones keeping you up at night or making it hard to lift your arm. Latent ones only hurt when pressed-like a ticking time bomb. Many people have latent trigger points without knowing it, until an injury or stress wakes them up.

What makes them so painful? Inside these knots, your muscle cells are stuck in a constant contraction. They’re burning through energy, starving for oxygen, and dumping out chemicals like acetylcholine, serotonin, and substance P-substances that turn up the volume on your pain nerves. The pH in the area drops to around 4.3, which is as acidic as a lemon. That acidity keeps the pain going in a loop: muscle tightness → less blood flow → more chemicals → more pain → more tightness.

How Is Myofascial Pain Different From Fibromyalgia?

A lot of people confuse myofascial pain syndrome with fibromyalgia. They both cause chronic pain, but they’re not the same. Fibromyalgia is widespread. It hits both sides of your body symmetrically-both hips, both knees, both shoulders. The pain is diffuse, and pressing on tender spots doesn’t send pain radiating. It just hurts right there.

Myofascial pain is different. It’s regional. One side of your neck. One shoulder blade. One side of your head. And the pain doesn’t stay put. It refers-meaning it travels along predictable paths. A trigger point in your levator scapulae (a muscle connecting your neck to your shoulder blade) can make your inner shoulder burn. A trigger point in your temporalis (a jaw muscle) can cause forehead pain or even mimic migraine symptoms.

Doctors have a way to tell them apart. Fibromyalgia has 18 tender points, all in specific locations, and they’re painful only when pressed. Myofascial pain has trigger points in taut muscle bands, and they cause referred pain, a local twitch when touched, and often a popping sensation under the fingers. If your pain follows a pattern-like always radiating from your right shoulder to your thumb-it’s more likely MPS.

What Causes Trigger Points to Form?

Trigger points don’t appear out of nowhere. They’re triggered-literally-by something. The most common causes:

  • Posture: Sitting hunched over a desk all day? That’s a recipe for trigger points in your upper traps and levator scapulae. Forward head posture increases their prevalence by 3 to 5 times.
  • Injury: A car accident, even a minor one, can leave behind trigger points. Up to 70% of people with whiplash develop MPS within weeks.
  • Overuse: Repetitive motions-typing, lifting, playing an instrument-can overload muscles and create knots.
  • Structural issues: If one leg is even 1 centimeter shorter than the other, your pelvis tilts. That stresses your lower back, hips, and glutes, leading to trigger points.
  • Systemic factors: Low vitamin D (under 20 ng/mL) is linked to a 60% higher chance of MPS. Hypothyroidism shows up in 15-25% of chronic cases. Poor sleep and stress make everything worse.

It’s not just one thing. It’s usually a combo. You sit too long. You get a minor injury. You’re stressed. Your vitamin D is low. And suddenly, your shoulder won’t stop aching.

A therapist using a glowing needle to release a trigger point in the lower back, with energy waves and healing symbols floating around.

How Do You Find a Trigger Point?

Finding a trigger point isn’t like finding a bruise. You can’t see it. You have to feel it. A trained therapist will press along the muscle with their fingers, looking for three things:

  • A taut band-a rope-like tightness in the muscle.
  • A tender spot within that band-often the most painful point.
  • A local twitch response-when the muscle jumps or twitches under pressure.

That twitch is a big clue. It’s an involuntary contraction caused by the sudden release of acetylcholine. It happens in 70-85% of active trigger points. If you don’t get a twitch, you might not be on the right spot.

Some muscles are notorious for trigger points. The upper trapezius is the most common-65% of MPS cases involve it. Then come the levator scapulae, temporalis, rhomboids, and quadratus lumborum. If you have chronic headaches, check your neck and jaw. If your lower back flares up, look at your glutes and hips.

Self-checking works too. Use your fingers or a tennis ball against a wall. Roll slowly over the muscle. When you hit a spot that makes you gasp, hold it for 30 seconds. If the pain radiates, you’ve probably found a trigger point.

Trigger Point Release Techniques That Actually Work

There are several ways to release trigger points. Not all are equal. Some are quick fixes. Others offer lasting relief when done right.

Ischemic Compression

This is the simplest and most effective method for home use. You press directly on the trigger point with your fingers, a tennis ball, or a foam roller. Hold steady pressure until the pain drops by about 50%-usually 30 to 90 seconds. Then slowly release. Repeat 3-5 times. Do this daily.

Why it works: The pressure temporarily cuts off blood flow to the area. When you release, fresh blood rushes in, washing out the pain chemicals and bringing oxygen. Studies show 60-75% short-term relief.

Pro tip: Breathe deeply while pressing. Holding your breath tenses your muscles and makes it harder to release the knot.

Dry Needling

This is when a therapist inserts thin, solid needles-like acupuncture needles-into the trigger point. No medicine is injected. The needle itself causes a twitch response. That twitch breaks the sustained contraction.

It’s not magic. It’s physics. The needle disrupts the abnormal electrical activity in the muscle. Studies show 65-80% of patients get pain relief that lasts 4 to 12 weeks. It’s especially helpful for deep muscles you can’t reach with your fingers, like the piriformis or psoas.

Don’t try this at home. It requires training. A bad needle job can bruise or even puncture a lung (rare, but possible).

Spray and Stretch

This technique uses a cold spray (like ethyl chloride) on the skin over the area where the pain radiates. Then, the therapist stretches the muscle while the skin is numb.

The cold temporarily blocks pain signals, letting you stretch deeper without triggering a protective muscle spasm. It’s especially useful for neck and shoulder trigger points. Success rates are around 50-65%.

Instrument-Assisted Soft Tissue Mobilization (IASTM)

Therapists use small metal or plastic tools to scrape over the muscle. The tools help detect and break up adhesions in the fascia around the trigger point. It’s less about pressure and more about sliding the tissue layers apart.

Studies show 55-70% effectiveness. It’s great for people who’ve had long-term pain and feel “stuck.”

Low-Level Laser Therapy (LLLT)

This uses red or near-infrared light (808-905 nm) at low energy. It doesn’t heat the tissue. Instead, it stimulates mitochondria-the cell’s energy factories-to work better and reduce inflammation.

It’s painless. You feel nothing. But studies show 40-60% pain reduction over several sessions. It’s not a magic wand, but it’s a good add-on for stubborn cases.

Why Some People Don’t Get Better

Not everyone responds to trigger point therapy. And when it doesn’t work, it’s rarely because the technique is wrong. It’s usually because the root cause wasn’t addressed.

Here’s what goes wrong:

  • Only treating the symptom: You get a few dry needling sessions, feel better, and go back to your slumped posture. The trigger point comes back.
  • Bad technique: A therapist who doesn’t know where to press or how to interpret twitch responses can make things worse.
  • Ignoring systemic issues: Low vitamin D? Thyroid problems? Poor sleep? These keep trigger points active. Fix the muscle, but leave the chemistry unbalanced, and you’re fighting a losing battle.
  • No home maintenance: One session won’t fix years of tension. Daily self-care is non-negotiable.

A 2020 study of over 1,200 MPS patients found that those who combined manual therapy, dry needling, and daily stretching saw a 65% drop in pain. Those who didn’t stick with home care? Only 35% improvement-and most of them relapsed within 6 months.

A girl performing trigger point therapy at home with a glowing tennis ball, vitamin D orb, and posture-correcting magic.

What You Can Do at Home

You don’t need a clinic to manage myofascial pain. Here’s a simple daily routine:

  1. Heat first: Apply a warm towel or heating pad (set to 40-45°C) to the area for 15 minutes. Heat loosens the muscle and increases blood flow.
  2. Ischemic compression: Use a tennis ball or foam roller. Target the tight spots. Hold for 60 seconds. Repeat 3 times per spot.
  3. Stretch gently: After compression, stretch the muscle slowly. Don’t bounce. Hold each stretch for 30 seconds. Repeat 3 times.
  4. Posture check: Every hour, sit up straight. Roll your shoulders back. Tuck your chin slightly. Set a phone reminder if you have to.
  5. Check your vitamin D: Get a blood test. If it’s under 30 ng/mL, supplement with 1,000-2,000 IU daily. It’s cheaper than endless therapy sessions.

One Reddit user, u/JawPainSufferer, said: “Ischemic compression taught by my PT helped my TMJ pain more than the $400 mouthguard.” That’s the power of simple, consistent action.

When to See a Professional

If you’ve tried home care for 4-6 weeks with no improvement, it’s time to see someone who knows trigger points inside out. Look for:

  • Physical therapists certified in dry needling or myofascial release
  • Chiropractors trained in trigger point therapy
  • Doctors with experience in pain management or sports medicine

Avoid providers who treat trigger points like a one-time fix. Good practitioners will teach you how to manage it yourself. They’ll ask about your sleep, stress, posture, and diet-not just your pain.

And if you’re being told you have “nerve damage” or “degenerative disc disease” but your imaging is normal? Ask if trigger points could be the real issue. Studies show up to 30% of patients diagnosed with radiculopathy actually have MPS.

The Bigger Picture

Myofascial pain syndrome is a quiet epidemic. It’s not glamorous. It doesn’t make headlines. But it’s responsible for 85% of pain complaints in some musculoskeletal clinics-and 30% of all primary care visits for muscle pain. And because it’s so misunderstood, people end up getting unnecessary MRIs, injections, and even surgeries.

What’s changing? The opioid crisis pushed medicine toward non-drug solutions. Trigger point therapy is now in the American Society of Anesthesiologists’ guidelines for chronic pain. Insurance is starting to cover dry needling. More therapists are getting trained.

But the real shift is happening in patients’ living rooms. People are learning to press their own knots. They’re checking their vitamin D. They’re sitting up straighter. They’re taking back control.

Myofascial pain isn’t your fault. But healing it? That’s your job. And you’re already on the way.

Can trigger points cause headaches?

Yes. Trigger points in the upper trapezius, levator scapulae, and temporalis muscles are among the most common causes of tension headaches and even migraines. The pain often radiates from the neck into the temple, forehead, or behind the eye. Many people who think they have migraines actually have trigger point-induced headaches. Releasing these knots often reduces or eliminates the headaches without medication.

Is dry needling the same as acupuncture?

No. Dry needling targets specific muscle trigger points based on anatomy and physical response. Acupuncture is based on traditional Chinese medicine and targets energy meridians. The needles look similar, but the technique, training, and goals are different. Dry needling aims to elicit a local twitch response; acupuncture does not.

Why do trigger points keep coming back?

They return because the root causes haven’t changed. Poor posture, repetitive movements, stress, low vitamin D, or sleep issues keep the muscles under constant strain. Releasing a trigger point is like popping a balloon-it helps temporarily. But if you keep blowing air into it, it pops again. Long-term relief requires fixing the habits and conditions that created the trigger point in the first place.

Can trigger points be seen on MRI or ultrasound?

Not reliably. Trigger points are biochemical and functional, not structural. Standard imaging shows bones, discs, and nerves-not muscle chemistry. Some research shows ultrasound can detect subtle changes in muscle texture, but it’s not used clinically for diagnosis. Diagnosis still relies on physical examination: finding taut bands, tender spots, and twitch responses.

Are trigger point injections better than dry needling?

For most people, no. Studies show lidocaine injections and dry needling provide similar pain relief at 4-week follow-up. Injections may give faster initial relief, but they’re more expensive and carry a small risk of bruising or infection. Dry needling is cheaper, doesn’t involve drugs, and can be just as effective. The key is not the method-it’s whether the trigger point is accurately located and properly stimulated.

How long does it take to see results from trigger point therapy?

Some people feel better after one session. Others need 3-5 sessions over several weeks. For chronic cases, it can take 6-8 weeks of consistent care-both professional and at-home-to see lasting improvement. The goal isn’t just to relieve pain, but to retrain the muscle and nervous system so it doesn’t revert to old patterns.

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13 Comments

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    Paul Huppert

    December 31, 2025 AT 17:57

    Been dealing with this for years. Thought it was just stress headaches until I found a PT who knew about trigger points. That one session with ischemic compression on my trapezius? Life changed. No more daily ibuprofen.

    Also, vitamin D was low as hell. Supplemented for 3 months and the nagging shoulder pain just... faded. Weird how the body works.

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    John Chapman

    January 2, 2026 AT 05:28

    THIS. 🙌 I was about to get a nerve block for my ‘migraines’ until my buddy told me to roll a tennis ball on my neck. I screamed. Then I cried. Then I felt 80% better. Dry needling next week. Fuck yeah, muscles.

    Also, stop sitting like a corpse at your desk. You’re not a statue. Move.

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    Urvi Patel

    January 3, 2026 AT 07:31

    Trigger points are just a Western medical fad. In India we’ve had yoga and ayurveda for 5000 years. You don’t need needles or balls. Just sit in padmasana, breathe, and let the prana flow. All pain is energy blockage. Your science is too mechanical.

    Also your vitamin D levels are irrelevant. You’re just scared of the dark.

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    anggit marga

    January 4, 2026 AT 04:55

    Y’all Americans think every pain needs a gadget or a pill. In Nigeria we just walk. We carry water on our heads. We squat. We don’t sit on chairs like lazy cows. Your muscles are weak because you’re soft. No need for dry needling. Just get off the couch.

    Also your ‘trigger points’ are just your body saying you’re weak

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    Joy Nickles

    January 6, 2026 AT 01:43

    Okay but like… have you even checked your cortisol levels?? Like, I’m not saying it’s NOT trigger points, but I had this same pain for 2 years and it was actually adrenal fatigue + low magnesium + gluten sensitivity + sleep apnea + myofascial issues… it was a whole thing. I had to do a 12-panel blood test, a sleep study, and a food diary. Also your posture is probably terrible because you’re on your phone 12 hours a day. And you’re not hydrating enough. And you’re probably using a pillow that’s too high. And you didn’t stretch after your last Zoom call. And you’re probably drinking coffee after 3pm. And…

    Also, I found this one Reddit thread from 2017 that said trigger points are just fascia adhesions and the whole thing is a scam. But I’m not saying that. I’m just saying… maybe check everything? Like, everything? Every single thing?

    Also, I’m not a doctor. But I play one on the internet.

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    Emma Hooper

    January 6, 2026 AT 20:32

    Oh honey. You’re not broken. You’re just overworked, under-slept, and emotionally constipated. Trigger points? They’re your body’s middle finger to your hustle culture. That knot in your neck? That’s your unspoken rage at your boss. That headache? That’s the guilt you never let yourself feel.

    Go cry. Hug someone. Eat a damn banana. Stretch like your life depends on it. And for God’s sake, stop scrolling. Your muscles remember everything you ignore.

    Also, vitamin D isn’t a supplement-it’s a lifestyle. Go outside. Touch grass. Let the sun kiss your skin. You’re not a vampire.

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    Martin Viau

    January 7, 2026 AT 08:42

    Empirical evidence for trigger point referral patterns is inconsistent across studies. The 2020 meta-analysis by Lee et al. showed heterogeneity in outcomes due to operator variability in palpation technique. Additionally, the placebo effect in manual therapies is often >40%. Until we have standardized, blinded RCTs with objective biomarkers (e.g., EMG microtwitch quantification), this remains anecdotal biomechanical speculation wrapped in pseudoscientific vernacular.

    Also, your ‘ischemic compression’ protocol lacks temporal resolution. Did you control for autonomic nervous system modulation during sustained pressure? Probably not.

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    Marilyn Ferrera

    January 9, 2026 AT 07:41

    This is spot-on. Trigger points are real. The science is solid. But most people skip the maintenance. You can’t fix years of tension in one session. Consistency > intensity.

    Heat before pressure. Breathe through it. Stretch after. Do it daily. Even 5 minutes. Your body will thank you in 6 weeks.

    And yes-vitamin D matters. Get tested. Don’t guess.

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    Robb Rice

    January 10, 2026 AT 05:24

    Great post. I appreciate the clarity and evidence-based approach. I’ve had MPS for 7 years. Dry needling helped, but only when paired with daily foam rolling and posture correction. I set a timer to stand up every 45 minutes. It’s boring. But it works.

    Also, my D level was 18. Now it’s 48. No more morning stiffness. Simple fixes, honestly.

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    Harriet Hollingsworth

    January 11, 2026 AT 22:13

    So you’re telling me I’ve been wasting money on chiropractors and massage therapists for 5 years… because I didn’t know to use a tennis ball? I feel like an idiot. And now I have to stop drinking soda? And get more sleep? And stop slouching? And check my vitamin D? This is too much. I just wanted a pill.

    Also, I hate that you’re right.

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    Deepika D

    January 12, 2026 AT 17:00

    Let me tell you something, my dear friends. Myofascial pain is not just a physical issue. It is a spiritual whisper from your body, begging you to slow down, to listen, to reconnect with yourself. I have seen people come to my yoga studio with chronic neck pain, and after just three weeks of breathwork, gentle stretches, and daily gratitude journaling, their pain dissolves like morning mist. The body remembers trauma. It holds it in the fascia. You don’t need needles. You need stillness. You need to sit with your pain, not fight it. Let it speak. Let it heal. And yes, vitamin D helps-but so does singing to the sun every morning. Try it. I promise, your soul will thank you. And your muscles will melt like butter on warm toast. You are not broken. You are becoming. 🌞💛

    Also, I teach a 20-minute morning flow every day on YouTube. Link in bio. No charge. Just love.

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    Bennett Ryynanen

    January 14, 2026 AT 08:29

    My ex used to say I was ‘too tense.’ I thought she was being dramatic. Then I rolled a lacrosse ball on my glutes and screamed like I was being stabbed. Turns out I had a trigger point the size of a walnut. Now I do it every night before bed. Best 90 seconds of my day.

    Also, I’m not gonna lie-I used to think this was all hippie nonsense. Now I’m the guy who carries a tennis ball in his pocket. I roll it on my desk. In the car. In line at the grocery store. My coworkers think I’m weird. I don’t care. I’m pain-free.

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    Chandreson Chandreas

    January 14, 2026 AT 11:10

    Been there. Done that. The tennis ball trick works. But the real game-changer? Sleeping on your back. I used to sleep curled up like a shrimp. My neck was a mess. Changed to flat on my back with a thin pillow. 80% better in two weeks. No needles. No supplements. Just sleep. Your body’s repair mode runs at night. Don’t sabotage it.

    Also, if you’re reading this on your phone in bed… put it down. 😊

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