The following symptoms suggest active or latent trigger points:
• Limited active and/or passive mobility in lengthening (stretching) or shortening of the affected muscle. A significant stiffness in movement may be felt.
• Weakness of the affected muscle
• Referred pain in characteristic patterns that are defined for each muscle. In active trigger points, the referred pain occurs during activity, rest, or palpation of the point. Latent trigger points form the typical pattern only during diagnostic palpation.
Muscular stiffness and weakness are especially noticeable after longer rest periods or generally after inactivity. Typical examples are morning stiffness or the muscular start-up pain after prolonged sitting.
The manifestation of symptoms and palpatory sensitivity of active trigger points can change within hours or from day to day. The symptoms of trigger point activity can outlast the triggering cause by a long time.
Other symptoms that can be caused by trigger points include:
• Vegetative changes in the zone of the referred pain, such as local vasoconstriction, sweating, increased lacrimal and nasal secretion, increased pilomotoric activity (goose bumps).
• Disturbed depth sensitivity
• Disturbance of equilibrium, vertigo
• Change in motorneuron activity with increased irritability
• Impaired muscular coordination ■ Supporting Factors
Factors that support the formation of trigger points include:
• Acute muscular overstrain
• Chronic overwork with excessive tiring of the muscle
• Direct trauma
• Under-cooling (muscular activity without previous warm-up)
• Other trigger points
• Disease of the internal organs
• Arthritic joints
• Segmental reflectory dysfunction (see Chapter 18)
• Negative stress (distress)
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