TrPs in the sternocleidomastoid muscle (in the neck) alone can cause: clumsiness; blurred or double vision, tension headaches; runny nose; maxillary sinus congestion; spatial disorientation; unintentional veering, or cause patterns of light and dark (such as shadows along the road or escalator treads) or head motion to result in dizziness (among many other symptoms), and if you know this, you may save worry and unnecessary testing and be able to do something to relieve the symptoms. If bottom of your feet feel like you're walking on broken glass as you take your first steps in the morning and you know this may be due to TrPs, you can do something. Roll up a big towel and put it under your blanket at the bottom of the bed so that your feet can rest on it. That avoids the allowing the plantar fascia to remain shortened overnight. (Keeping muscles in a shortened position is a common TrP perpetuating factor.) Chronic pelvic pain that feels like it comes from organ disease can come from TrPs. (2) If you believe that these symptoms come from FMS, there is nothing to do for them but attempt to control the pain. Understanding TrPs and their perpetuating factors can give you some measure of control over your symptoms and your life.
We know what TrPs cause specific symptoms, what their perpetuating factors are, and what to do about them. These topics discussed in detail in medical texts such as Travell and Simons' Myofascial Pain and Dysfunction: The Trigger Point Manuals. For example, the prickling tingling painful sensation along the jaw line that can move upward across the cheeks is caused by specific TrPs in a muscle called the platysma (15 p 82) and not by FMS. If the TrPs are treated and the perpetuating factors brought under control, the symptom will go away. If the perpetuating factors cannot all be identified or controlled, the TrP can still be treated and minimized.
When active (pain causing) TrPs become latent, they no longer cause pain, but they still cause restricted movement and muscle weakness. The latent TrPs still electrically inhibit the muscle. Some people don't exercise because if they don't move they don't hurt as much. This is false reasoning. Their TrPs have merely become latent. Even a minor stressor can become a life-altering event if you have latent TrPs. Myofascial TrPs can cause: bloating, incontinence, impotence, rectal pain, sore throat, tender neck and armpit "swollen glands" feeling, muscle pain, headaches, pain in joints without swelling, dizziness, autonomic symptoms, weak muscles, ear pain, restricted range of motion, knee pain, shoulder pain, wrist pain, hand pain neck pain, back pain, abdominal pain, pelvic pain, pain in the outer or inner vaginal area, stiffness in the morning (and after any immobility), shortness of breath, chest pains, tightness in the chest, frequent nighttime urination, inability to empty the bladder fully, stiff neck, nasal congestion, trouble swallowing, hoarseness of voice, tearing eyes, gastroesophageal reflux, vomiting, heart arrythmias, ringing ears, painful or itching ears, growing pains, painful menstrual periods, irritable bladder or bowel, belching, diarrhea, rapid racing heartbeat, painful intercourse, and many, many more symptoms.
If you have back pain that worsens with sitting but it improves with appropriate therapy, check for iliopsoas and quadratus lumborum TrPs. If the pain is in the hip and radiates down the back of the leg, check the piriformis muscle in the buttock for TrPs. If pain radiates down the side of the leg, check the side of the hip for the gluteus minimus TrPs. Myofascial TrPs can refer symptoms a good distance away from their location. TrPs in the scalene muscles of the neck can entrap lymph and blood vessels, causing swelling in the hands in the morning. They can cause tightness and pain in the chest and down the back of the arm in a specific pattern, including the top of the thumb and index finger. You and your care providers need to become familiar with the common TrP referral pain patterns. They can be very specific and are generally similar from person to person, so if you can identify the pain pattern you can find the TrP.
