1. Trapezius Trigger Points
- Muscle Action: Elevates, depresses, retracts, and rotates the scapula; also helps extend and laterally flex the neck.
- Origin: Occipital bone, ligamentum nuchae, and spinous processes of C7 to T12.
- Insertion: Lateral third of the clavicle, acromion, and spine of the scapula.
- Referral Patterns: Pain often refers to the temple, jaw, and behind the eye, mimicking tension headaches or TMJ issues.
- Mimicked Pathologies: The pain from trapezius trigger points can be confused with tension headaches, migraines, or even sinus issues.
- Differentiation: Trigger point pain tends to worsen with specific neck or shoulder movements and is usually alleviated by massage or stretching. Tension headaches, by contrast, are often linked to stress and are persistent regardless of neck movement.
2. Levator Scapulae Trigger Points
- Muscle Action: Elevates the scapula and rotates it downward.
- Origin: Transverse processes of C1 to C4 vertebrae.
- Insertion: Superior part of the medial border of the scapula.
- Referral Patterns: Pain radiates along the inside of the shoulder blade and into the neck, often causing a stiff neck.
- Mimicked Pathologies: This trigger point can be mistaken for a cervical disc issue or even shoulder impingement syndrome.
- Differentiation: Unlike a cervical disc problem, which may cause neurological symptoms (numbness, tingling), levator scapulae trigger point pain is localized and can be eased by stretching and pressure on the muscle itself.
3. Infraspinatus Trigger Points
- Muscle Action: Lateral rotation of the arm and stabilization of the shoulder joint.
- Origin: Infraspinous fossa of the scapula.
- Insertion: Greater tubercle of the humerus.
- Referral Patterns: Pain often refers down the arm, sometimes as far as the hand, mimicking symptoms of carpal tunnel syndrome.
- Mimicked Pathologies: The arm pain can be confused with cervical radiculopathy or carpal tunnel, especially when numbness or tingling is present.
- Differentiation: Infraspinatus trigger points usually worsen with overhead or reaching movements and are relieved by stretching the rotator cuff muscles. A cervical radiculopathy will often show signs of nerve compression, such as changes in reflexes or strength.
4. Gluteus Medius Trigger Points
- Muscle Action: Abduction and medial rotation of the thigh; stabilization of the pelvis.
- Origin: Outer surface of the ilium, between the anterior and posterior gluteal lines.
- Insertion: Lateral surface of the greater trochanter of the femur.
- Referral Patterns: Pain radiates to the sacroiliac region, low back, and lateral leg, often mimicking sciatica.
- Mimicked Pathologies: Gluteus medius trigger points are commonly mistaken for sacroiliac joint dysfunction or lumbar spine issues like herniated discs.
- Differentiation: True sciatic pain typically follows a dermatomal pattern and is accompanied by neurological deficits (like weakness or numbness). Trigger point pain, however, is typically confined to a specific region and may feel achy rather than sharp.
5. Piriformis Trigger Points
- Muscle Action: Lateral rotation of the thigh and stabilization of the hip joint.
- Origin: Anterior surface of the sacrum and sacrotuberous ligament.
- Insertion: Superior border of the greater trochanter of the femur.
- Referral Patterns: Pain can radiate down the back of the leg, similar to sciatica.
- Mimicked Pathologies: Piriformis syndrome is often mistaken for true sciatica, as the sciatic nerve runs directly under or through the piriformis muscle.
- Differentiation: While both conditions cause similar radiating leg pain, piriformis syndrome does not typically present with lower back pain or neurological deficits, which are common with herniated discs or lumbar radiculopathy. Pressure on the piriformis muscle can increase pain, whereas lumbar disc issues may show different patterns on MRI.
6. Quadratus Lumborum (QL) Trigger Points
- Muscle Action: Lateral flexion of the vertebral column and stabilization of the 12th rib during respiration.
- Origin: Iliac crest and iliolumbar ligament.
- Insertion: Inferior border of the 12th rib and transverse processes of L1-L4.
- Referral Patterns: Pain refers to the lower back, hip, and groin, often mimicking kidney pain or lumbar spine pathology.
- Mimicked Pathologies: QL trigger points can be confused with kidney stones, low back pain due to herniated discs, or even gallbladder issues.
- Differentiation: True kidney or gallbladder issues are usually accompanied by other systemic symptoms like fever, nausea, or blood in the urine. Trigger points in the QL are often aggravated by twisting movements and improve with stretching.
7. Sternocleidomastoid (SCM) Trigger Points
- Muscle Action: Flexes and laterally rotates the neck; assists in elevating the thorax during respiration.
- Origin: Manubrium of the sternum and medial portion of the clavicle.
- Insertion: Mastoid process of the temporal bone and superior nuchal line of the occipital bone.
- Referral Patterns: Pain refers to the forehead, eye, and ear, commonly leading to symptoms of dizziness, vertigo, or even sinus-like pressure.
- Mimicked Pathologies: SCM trigger points can be mistaken for migraines, sinusitis, or even ear infections.
- Differentiation: SCM trigger points are exacerbated by head movements, whereas true migraines and sinusitis are often related to hormonal or environmental triggers.
How to Tell the Difference: Key Tips
- Trigger points generally cause pain that can be reproduced by pressing on the muscle itself. They often feel better after massage, stretching, or heat therapy.
- True pathologies like nerve impingements, organ issues, or joint dysfunctions often have more persistent symptoms and may be accompanied by systemic signs (fever, swelling, numbness).
- Movement-based testing: Trigger point pain will typically worsen with specific movements or direct pressure on the muscle. If pain persists despite these interventions, further diagnostic testing (like imaging or lab work) might be warranted.
Conclusion: Empower Yourself to Recognize and Treat Trigger Points
Muscle pain can be a frustrating mystery to solve, especially when it mimics more serious conditions like nerve entrapments, migraines, or even kidney problems. But by familiarizing yourself with common muscle trigger points, you can take the guesswork out of managing pain. The good news is that most trigger points can be effectively treated with targeted therapies like chiropractic care, massage, stretching, and strengthening exercises.
Remember, the body is an interconnected system, and what might feel like a problem in one area is often caused by an issue somewhere else. If you’re experiencing pain that seems to come and go or doesn’t respond to traditional treatments, it might be worth considering muscle trigger points as the root cause. With a little knowledge and the right treatment, you can stop chasing pain and start focusing on living a healthier, more comfortable life.
And if you're unsure where to begin, a healthcare professional like a chiropractor can guide you through the process of identifying and treating muscle trigger points. At Awesome Family Chiropractic, we specialize in uncovering the hidden sources of pain and using a holistic approach to help our patients feel better, move better, and live better. Don't let chronic muscle pain hold you back — relief is possible when you understand how your muscles work and how to treat them right.
This blog is for educational purposes only and not a substitute for professional medical advice. Consult a healthcare provider before starting any new treatment. Outcomes and experiences discussed may vary. For immediate medical concerns, contact your physician.
