• Dr. Donald Littlewood

The Ugly Truth About Muscle Pain

At some point, we have all experienced muscle pain. But what is it, and why does it happen?

The root of it all is trigger points.

Trigger points are small, palpable nodules in very sensitive, taut areas in a muscle. They can be broken down into two forms: active & passive.

  • Active trigger points cause spontaneous pain at rest and that pain is increased when there is stretching or contraction involved. There is also often a decrease in range of motion.

  • Latent trigger points do not have this spontaneous pain but it still can cause pain when palpated and restricts range of motion.

There are some overarching characteristics that all trigger points have in common:

  • Focal point of tenderness to palpation of the muscle involved causing a reproduction of the complaint

  • Presence of a taut band of musculature

  • Restricted range of motion

  • Pseudo-weakness is often involved

  • These buggers play a role in tension headaches, low back pain, neck pain, jaw pain, forearm & hand pain, postural pain & pelvic/urogenital pain.

So why/how do we get these?

The going idea is that these arise out of chronic micro-trauma in the area. In my practice, I see a lot of trigger points in the upper back, neck and head.

In order to fully explain this, I’m going to get a touch science-y on you. It’ll be short. I promise.

So when a muscle contracts, the nerves release a chemical called acetycholine (ACh). Trigger points are known to have an increase in ACh released and therefore there is a sustained shortening of the cellular fibres of the muscle.

This shortening (or contraction as we call it) causes a increase in the local energy consumption and a decrease in local circulation.

All this to say: there is a decrease in oxygen and blood flow, so the muscle cannot do the job it wants/needs.

Okay. Science over.

So you have trigger points

Okay, so you might not have active ones RIGHT NOW, but I would be willing to bet some cash that you’ve had one in the past, and that you’ll have more in the future.

Sorry ‘bout it!

Along with these trigger points often comes joint restrictions and always comes with a decrease in range of motion. And that’s where I come in.

My Approach to Treating Trigger Points

Now obviously I treat the muscle… that’s a given. But how?

Myofascial Release

This is a go-to for me. Essentially I find, and apply pressure to the trigger points and take you through a range of motion. Is it comfortable? No. Does it feel good? Yes.

I like to call it the good pain.

Trigger points respond to tactile pressure. This will release the trigger points and slowly melt them away. The release of the trigger point also releases lactic acid (because the muscle is contracted) so I tell my patients to drink lots of water after treatment to flush it all out.


This is essentially magic.

There are traditional acupuncture points, and then there are functional acupuncture points, and I use both. That being said, around ~70% of the traditional acupuncture points are found where common trigger points lie.

The Ancient Chinese were onto something!

Inserting acupuncture needles directly into the trigger point, or at nearby spots, can cause the trigger points to literally melt away.

I also usually add some electrical stimulation to the area. The electricity activates the muscles to fire in a more appropriate & efficient manner and really speeds up the healing process.


Trigger points are often associated with joint immobility in the area. For example, when the trapezius & levator scapula have trigger points, the neck is usually pretty jammed up too.

Adjustments are aimed at getting the joints that aren’t moving, moving again. It is a quick, small, specific movement that provides patients with a lot of relief.


Stretching is SUPER important with trigger point work. You want to make sure you are properly stretching the muscles with the trigger points in them before you start to strengthen.

This is because if you overwork an already sore and painful muscle, it is just going to get more sore, and more painful.

So stretch first, and then strengthen.

Want to know what stretches to do? Leave a comment and I would be happy to point you in the right direction.

Final Thoughts

At some point, you will have trigger points, if you haven’t already; I have one in my right trap as I type this. Getting your muscle aches looked at and taken care of by a healthcare provider will not only help them in the moment, but will help in the future too.

In health,

Dr. Donald Littlewood

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