Self Treatment – Trigger Points for Neck Pain

Your neck is one of the commonest places to get myofascial triggers – and no wonder! Your neck muscles are working every waking hour of your day. They’re constantly supporting your head, adjusting your posture and working with your shoulder muscles.

Around 50% of people will have an episode of significant neck pain during their lifetime, and it can really affect your quality of life.

Treating neck pain effectively means figuring out exactly what the cause is. This is sometimes complex, as the neck has a number of important structures, all of which can cause pain.

Neck pain can be caused by a problem in the discs or joints – especially facet joints. Then there’s the muscle, tendons, and ligaments of the neck. Finally, in the muscles, you can get pain caused by active trigger points. Here are the main symptoms of active trigger points in the neck:

  • Neck pain and stiffness
  • Tension headaches and pain behind the eyes
  • Pain going down into the chest
  • Shooting pains down the arm

Especially for people with office jobs, knowing how to self treat your trigger points for neck pain is vital. Why office jobs? If you’re sitting at a computer all day, take a moment to look around your office. In all likelihood, you’ll see your fellow workers slumped or hunched over their desks in varying degrees of tension.

Because you’re focusing on what’s going on your computer screen, it’s all too easy to forget how you’re sitting. And doing this for eight hours a day, five days a week (or more!) all adds up.

Here are the main neck muscles which get trigger points:

  • Scalenes
  • Upper Trapezius (shoulder muscles, but can refer pain up into your neck)
  • Suboccipitals
  • Levator Scapulae
  • Sternocleidomastoid

There are other muscles that refer pain into the neck, and we recommend you check the free trigger charts at www.TriggerPointCharts.com to get a full picture.

So, first things first – what’s a trigger point? The short definition: it’s an area of micro-spasm within your muscle. It’s like your muscle has switched on a tight knot, which isn’t able to relax.

Why does your body do this? It’s part of a defensive reflex. Your muscles naturally contract when they feel they’ve been stretched too far. But for many people, parts of the muscle don’t release, and this leaves behind small ‘trigger points.’

While some people get these triggers from a physical accident, it’s equally common to get triggers from sitting for a long time in a position where you’re putting strain on your muscles. (Like sitting with your neck in an awkward position.)

How to Treat Trigger Points for Neck Pain

What to Look for in a Treatment

Now, if you take an area that’s super sensitive and you treat it, and the treatment is too rough and too intense, it becomes very easy to make the pain worse and hype everything up. This can happen if you or your trigger point therapist are trying to kill the trigger by putting too much pressure onto an area where all the lights are on already. It’s like getting a sunburn and then doing something to the whole area–it just hurts like crazy.

So the treatments have to be very gentle. To avoid an unnecessarily painful treatment experience, it’s a great idea to learn how to treat your own trigger points in a gentle way so that you don’t cause any negative reaction. If your system is all wound up, doing too much to it will make it worse.

The reason for this is that the messages going from your nerves up into your brain can be changed or amplified. When you have chronic pain, your whole pain system–the nerves from your muscles into your spine, all the way up into your brain–is hyped up.

This means unless you are careful, you’ll end up feeling far more pain than you would when your pain system behaves normally.

So, how do you self treat the trigger points for neck pain? Firstly, you need to be able to find trigger points. You’ll be looking for tight or thickened bands of muscle within an area that feels tender.

Your trapezius is a very common muscle to have trigger points. The main trigger point here is a big trigger point which can be a little difficult to treat. For the trapezius trigger–and there are two points–you have to pincer the muscle between thumb and fingers. But because it’s such a big trigger, you worth taking your time. This trigger point may require multiple treatments to release.

Trapezius – the Most Common Neck Trigger Point

Neck Muscle Ischemic Myofasical Release

Feel up behind your head. When you find a point, take the tip of your finger, put another finger over it, and feel for the trigger point. If you run your fingers backwards and forwards, you may feel a little band, like a little guitar string, and along that band, you’ll find a sore point. That’s the active trigger point.

Your goal is to sneak up on the trigger point and put it to sleep.

Once you’re on the point, push hard enough to be sure it’s sore, so you know you’re definitely accurately on the trigger point.

Reduce the Pressure

Gradually reduce the pressure until there is no pain. You’re still on the trigger itself, but you’re pushing just hard enough to know you’re there–not hard enough to cause pain. You can do this as well as any therapist (in fact better) because you can feel exactly when the pressure is right.

Relax

Now, breathe and relax. You just close your eyes and send a message from your mind through your finger to the trigger point. And you say to the trigger point, “Just relax. Chill out. You don’t need to protect me anymore because I don’t need it.” Just quietly do this for 20 or 30 seconds.

Increase to Create Ischemic Pressure

After this, start to gently increase the pressure on the spot. You haven’t moved; you can’t move a millimeter if you want to stay exactly on the trigger point.

Slowly increase the pressure over 90-120 seconds, always keeping below the point of pain. Gently increase the pressure and you will find over time that as you start to push, it doesn’t hurt.

When you can push quite hard, and feel no pain, this means the trigger point is released, deactivated, turned off.

Once you’ve done this, feel around for other triggers and treat them in exactly the same way. The triggers in the smaller muscles will be easier to treat. They should go away quicker.

After you’ve treated yourself, lie down and relax. If you have a heat pad, hot water bottle or wheat bag, put this on the area you’ve treated for 5 minutes or so.

Stretch Your Neck Muscles

After treating trigger points and applying heat, stretch your muscles. This is an important part of the process, and will help the treatment last longer.

Here’s a video on how to safely stretch all your neck muscles.

Do this once or twice a day, very gently, just chipping away slowly. You will find that your pain starts to reduce.

Take into account that your pain may not be completely alleviated in two or three treatments. If it did, that would be miraculous and wonderful.

However, you know now that trigger points are a big part of getting rid of muscle and joint pain; now you need to very quietly and gently start to treat your own trigger points.

If you want to take this to the next level and start treating triggers right now, my Trigger Point Course covers every major muscle, with step by step video tutorials.

Finding All the Neck Trigger Points

A key with trigger points – they can refer pain to other locations. For example, triggers in your neck can refer pain up into you head – even causing what seems to be a tension headache. Trigger points in your shoulders and upper back can refer into your neck.

If you press on a spot in your neck that causes pain shooting up into your head – you’ve found an important trigger.

It’s also important to note that trigger points are just one possible cause of neck pain. While treating your triggers you need to also rule out other causes like disc injuries in the neck, tumors, and in the case of chest pain, any heart trouble.

That said, trigger points may be secondary causes of pain. This means they can be set off by other problems like facet joint or disc pain.

Active neck trigger points then become part of the general neck pain complex. And even after the other problems have settled, these active triggers can continue to cause pain. So it’s well worth going on a search to see if you can find and switch off active trigger points in your neck.

Some people also use a Theracane for neck pain (a cane with knobs you can use to apply pressure to your muscles instead of with your fingers) or a knobble board (same idea, but you can lie down on it.)

Both types of devices work well, however so do your own fingers, and especially when you’re learning, you need all the feedback sensation and sensitivity you can get.

Sleeping with Neck Pain

Here’s a common scenario: imagine you woke up one morning, and one of your neck trigger points was in spasm. Unfortunately whoever you saw didn’t examine you properly or didn’t understand about trigger points.

Despite the common nature of trigger points, doctors don’t always diagnose or treat them properly. Because of this, it could take years to find the problem. The problem with this scenario is that the trigger points would have been there all those years, and so the whole area has become sensitized.

Not only do you have the trigger point in your muscles–the trapezius, the muscles up the back of your neck, your splenius capitis– all of these can be in a protective spasm. In addition, all the nerves in that area are wound up and the messages coming into the spinal cord are amplified. This makes the whole area super sensitive and painful.

If you want to find and treat all your neck trigger points, here’s where to get a free manual and starter trigger point course >>

Leave a Comment:

(55) comments

La Shonda April 19, 2010

I’m so greatful for this I am about in tears. I have been struggling with myofascial pain and was telling my husband I had to find some kind of remedy for the pain I don’t want the meds just want some relief and then this I just stumbled across thank God. I have not had this much relief since my diagnosis in November I’m so very grateful I will do these things daily it’s totally awesome!!!

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    Jonathan April 29, 2010

    Hello La Shonda

    I am so pleased to hear you are getting real benefit from the treatments on the site. Keep up the good work!

    Kind Regards
    Jonathan

    [Please note- I cannot suggest a specific treatment for your complaint as I have not taken a full history, examined you or reviewed your investigations.
    Therefore all comments I make can only be general – relating broadly to the problem you have described. ]

    Reply
mercy September 16, 2010

Dr. J. Kuttner
I would like to thank you for all the support and information that you send me by E-mail, about having trigger points , myofacial, and muscle spasm. It started when I fall 4 feet from a 5 step ladder backward to a steel flooring at work, I had concusion and was send to the hospital. I had a lumbar spine injury, and neck.Since you were sending me all the exercise and how to find trigger points ,it was so relieve that I”m back to my work full time again. But I have one more problem ,I notice that I have tingling in my left hand and my fingers are getting numb you think its related to my injury?
because my left side was the one that was injured the most. But my Doctor told me it was carpal tunnel. I”m still waiting for the test result from last two weels ago. Doctor can you help me?

Thank you so much and God Bless

Mercy Manalo

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    Kristy February 26, 2015

    Wow! Same exact symptoms as me. I fell down a flight of 10 stairs 3 years ago and have been in pain ever since, with my left side being worse. I have had pain go down my arm as well. Did you get a resolution?

    Reply
Susan Howard December 12, 2010

Dr. Kuttner, you have been a Godsend to me. Not only am I able to help myself relieve my osteoarthritis pains, but as a student massage therapist and having to do 25 massages and find my own people to do them on in order to graduate, I have used the information sent by email to help others. I’m very excited about this.

Also, because of the information you forwarded me to help me with my NeuroMuscular/Trigger Point presentation in class, I got an “A” for the assignment with the teacher’s comment “Great Report.”

Thank you so very much. If I ever get the opportunity to go to New Zealand, I want to meet you in person. Keep up the good work. You are helping so many people through your work and website.

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Linda Cohen May 12, 2011

Much of what you are teaching I have already learned and use. It has been helpful to me in that it confirms that my self-treatment is accurate. I think emotions of anxiety, worry, and fear all increases the pain. The more one focuses on one’s pain the worse it becomes.
Knowing that others suffer from the same symptoms is very helpful.

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[…] Click the link below to learn how to self treat triggers in your neck: Neck Myofascial Trigger Points. […]

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Jay M. Lenny July 27, 2011

Hi _ How do I find a physician in my area that uses this treatment? My zip code is 30096. Thank you.

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Leanne Smith August 11, 2011

I have been experiencing pain on the right-hand side of my head for some time. It feels more like pressure and can make me feel dizzy and disorientated. I have a lump above my temple. The top of my scalp is pink and very tender. This is worse now than ever and makes me feel like this is something very serious.

Does this sound like trigger points to you ?

Thank you

Leanne

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Dave G. October 5, 2011

One word – THERACANE.

The doctor refers to it here and it will do wonders for you. I have suffered with should pain for going on 7 years now, and once I bought a Theracane (2 days ago, by the way), the pain is on it’s way out. I now realize that my shoulder was so locked up, so deep down, that everything hurt. I knew I needed to get in there deep and really work it out, but I could not do it with my own fingers and any massage that I got just didn’t cut it. I used a Theracane many, many years ago for my back and just rediscovered them and bought one on Amazon for $29. I promise you that if you have deep pain caused by trigger points (even if you didn’t know what the heck a trigger point was), this amazing little tool will be a miracle for you. My wife and kids laugh at me when I use it since you look a bit silly, but I don’t care. It’s a lifesaver.

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Interesting Dame January 28, 2012

Just a suggestion Dr. Your first sentence has a misspelled word. Actually it’s a made up word. There is no such word as “commonest”. It’s “most common”. Other than that…great job and way to go on helping so many people. 🙂

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    Anonymous January 15, 2015

    Actually, “commonest” is definitely a word…though, seldom used. (I’m an English professor.)

    Reply
    shelley April 17, 2016

    Will I’m sure that was very helpful to all!!!

    Reply
      shelley April 17, 2016

      I mean well!

      Reply
Frankie T January 21, 2013

Wow… My hat is off to you, I have been struggling with upper back pain (in between my shoulder blades and spine) for about 6 months. I can’t even begin to tell you how much relief I have now. As I pressed down into my clavical area,(the soft spot behind it) I got a shooting pain right in between the shoulder, where it’s been hurting me. I followed your directions to reset the point and I think it’s working good. The muscle seems to tense up now and then but I apply the process and the pain retreats.

I thank you so very much for the tips. And for anyone with pain in the upper back, look into the SCALENE muscles…… Ahhhhhh so much better…..

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neelima May 3, 2013

Sir it was superbly explained thanks for the great info am a physiotherspist and type of pain comes in acessing daily.

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leecolima.no-ip.org June 16, 2013

My partner and I stumbled over here coming from a different website and thought I may as well check things out.

I like what I see so i am just following you.
Look forward to looking over your web page
again.

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Frank Social September 20, 2013

Thank you so much for the explanation about trigger points. I’ve had some de-stressing massages from skilled persons, and know when and where they hit on a trigger point. But I’ve never been able to achieve the same result myself, even though I could easily find the trigger point. Now I understand how it works and have just removed enormous stress from my neck (computer and stress driven) – finding the trigger points – and applying your technique. I feel great. Thankyou for literally changing my life

Frank

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Monique Tolle October 29, 2013

Please send me any info you can give me on self treatment for tension headaches. I have had headaches for 30 years now and don’t go one day without at least otc pain relievers. I have tramadol which helps greatly, but I can only take it every other day. I would rather just not have so many darn headaches then I wouldn’t have to use so much pain reliever. My shoulders are incredibly tight, I have been told. They are. Then there is the once a month or at least every other month migraine I get. If there was only something to knock me out when I get those, I’d be so grateful. Those are hormonol and my gyn is trying to help with that.

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Ana Johnson November 4, 2013

I continue to appreciate and learn from your brilliance.
Thank you

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aruna April 13, 2014

Dear Dr. JONATHAN, This is an extra ordinary effort from you. congratulations. this article will benefit for all other medical professionals.i learned lot of things. kind regards. triple gem bless you.

Reply

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Barbara Gronet July 30, 2014

I’d like to receive more information via email on trigger point therapy. Thank you.

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ปวดเอว September 15, 2014

There are so many causes of back pain, that it’s hard
to find a cure- all for it. inch thick piece of board under your mattress if you are on a budget.
Thank you for stopping by today and I hope these natural remedies
for back pain do you the world of good.

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aisha October 14, 2014

Kindly help.. too many tight muscles at the back of my neck.
Thanks

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shanda ouch October 21, 2014

aagh my right shoulder and neck cant hardly turn head without pain in neck move my arms pain in neck and since I moved from Arizona to California my dear friend Stephanie is too far away to hit my trigger points and fix me , cant seem to find a soul that knows what to do without makin it worse. only thing left to do know is figure a way to do it myself . cant afford to do it any other way , got children to take care of interaction is hard and painful
please h

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Tal December 28, 2014

I have a question: yesterday my husband got a sudden shot of pain at his right temple. The pain continued into a right headachy kind of pain that lasted for several hours. He says it happens on occasion. Does this sound like a tension related pain?

Thank you for caring about our aching backs and necks, and all the hidden, dormant points in our feet, things, calves, and who knows where else.

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    Naomi Kuttner December 30, 2014

    Hello Tal,

    If a headache is caused by muscle tension, then finding the trigger point in the muscle responsible should ease the headache. You can look for the most likely culprits for head pain here: http://www.triggerpointmaps.com

    Reply
Marie Loise Torio January 21, 2015

Hello Dr. I’ve been having neck pains ever since I was diagnosed with cervical spondylosia. I can also feel loads of knots in my trapezeus and clavicle area. I’m been going to massage parlour but it just gives me short term relief. Hope I can learn more from you about these trigeer points.. Thanks so much in advance.

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Monica February 17, 2015

I’m going to try this on my friend. I sure hope it works. He’s always got them, as do I. I can’t seem to get it to work on me.

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Angela varcasia February 24, 2015

I am a trainer and have been very interested in trigger point therapy. Would love to hear more! Thanks!

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Joanne Haynes March 9, 2015

Hi Dr Kuttner
Please can you help me as I've asked my Dr and also Physio about this but I still have this problem and pain…
Looking at my back and the muscle to right of my spine which spans from shoulder to where my bra strap ends across my back, the whole muscle aches constantly and feels tight. And an inch above my bra within the muscle is a cyst like lump which hurts when pressed.
Is there an exercise/stretch/massage for this area? Do you know what it is I have?
I am drug free now and have eliminated grains and dairy from my diet as was diagnosed with fibromyalgia 5 years ago.. Changing my Diet has had the biggest influence in eliminating pain 🙂
Thank you in advance.

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    Cindy Hatcher September 2, 2015

    I was seen for occipital neuralgia Injections between my c2-3

    Reply
kathy July 29, 2015

I have been suffering from post concussion symptoms for 4 months now. I have constant pressure in my head and was told it was Intracranial pressure. It’s been very depressing keeping me from daily activities as I feel as if I am walking around with a bowling bowl on my head.
Someone recently said it may be injury in my neck that is causing the pressure in my head and I should
think about getting it looked at for neck spasms and also working with trigger points. I’d be very interested in your information
Thank You!

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thathane August 17, 2015

i have recuring trigger points around the neck and upper back

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Mario Nunez September 24, 2015

Hello,

My wife experiences severe myofascial pain from her lower back all the way to the top of her head. She is to the point where she has to rely on strong medication in order to get a few hours of sleep but develops a quick tolerance to whatever the doctor prescribes. Her symptoms have not gotten better in the last few months but spread to different parts of her body. Please provide me with any and all information relating to helping her deal with this pain.

Thank you

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julie December 5, 2015

Hi I would be really greatful to recive your help as I have been suffering with neck problems even after acupuncture Im still suffer with on going neck problems at night even though I take muscle relaxents I have extreme pressure at the back of my neck and stiffness and as I generally lay sideways I feel my neck will not stay in the same position for long which then wakes me up feeling rather nauseous with a headache, and laying on the back of my neck I feel a pressure which is extremely uncomfortable I would love to know how I could change this as sleeping is becoming increasingly hard

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Jane December 26, 2015

I’ve been in physiotherapy for six weeks for Sternocleidomastoid pain on both left and right. I injured my neck when I had my head down as I was brushing my teeth….crazy when I put my head up there was a crunching crackle sound in back of neck and instantly felt pain on both sides and my turning to left and right was extremly limited. Prior to this my range of motion was excellent being able to turn with nose lined up to shoulder. The therapy has been pretty intense. My range of motion turning left and right seemed to have improved only slightly. I have been experiencing ear discomfort and few times quick spark like pain behind both ears at same time. Which cause me to respond with a shudder ouch! Also I have blocked sinuses (stuffy nose) when lying down for sleep…and back of throat discomfort.
From what I have read there is a connection to this SCM muscle problem that causes these symptoms. I’m starting to believe that the PT has been working to vigorously in manipulating my head…pulling up and forcing head turn positions to encourage increase in range of motion.
I am doing home exercises with bands and some 5 pound weights and working consistently in trying to improve my poster. I understand my poor posture is what got me to the point of SCM pain. I have decided to quit Physiotherapy….I believe it is worsening my condition not helping. The PT’s approach is too aggressive.
I appreciate any information you can share with me….I am determined to get my range of motion back to where it was. Thank you

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Lorraine doak March 19, 2016

Left side, tight neck and tender points in neck combined with sore shoulder!

Any help would be appreciated.

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Golda Friedler May 6, 2016

I have been suffering from headachesfor about 5-6 years. They usually start in the morning and – usually wear off during the day. I put it down to my age ( I am 80 years old ) as pain . relievers( which I take for other problems do not seem to help

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Ian Rigby August 15, 2016

Hello,
I have just read your article and it made a lot of sense and I would appreciate having you send me a free email information course on Trigger Points releases. Thank you

Ian Rigby

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Marlene September 4, 2016

Request for more information regarding trigger points please.

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Carol September 13, 2016

Hello, I have just returned from a massage that included an overly painful (to the point where I had to stop the massage). I went for a “sports massage” with a Thai influence as I’m in Thailand, and told them that I had some nerve pain in my neck, the back of my head and face due to some compression in my upper back.
The massage on the neck was FINE and seemed to release some key muscles that were in spasm there. I ordered a 1 hr massage, and she spent 25 minutes digging her fingers in to my scalp and shoving them around with such force that I asked her to stop at least THREE TIMES. She did NOT stop and I had to get up and ask for the manager. The therapist said she was doing something with trigger points and that my neck and scalp were extremely tight and she was trying to help.
My question is: is it supposed to be THAT painful and for such an extended amount of time? What is the technique that is used to release trigger points and should I have a headache and sore scalp? My feeling is that it should not be anywhere NEAR this painful. I am appalled at the lack of caring she showed towards my pain. A good therapist would ask how the pressure was and if there were certain trigger points, maybe warn you…not just dig around on your SCALP for so long. Thank you for any insight you can give on this to help me understand where she was coming from.

Reply
    Naomi Kuttner September 13, 2016

    Hi Carol,
    You’re quite right – it’s a common misconception that trigger point treatment has to hurt.
    In reality – when you use ischemic pressure in the way we recommend, you can ‘sneak up’ on the trigger point and switch it off without causing huge amounts of pain.
    Triggers in the top of the neck and shoulders (suboccipitals and upper trapezius) can cause headaches, so it’s well worth treating these (gently) for pain relief.
    The important thing to remember is that trigger points are a protective mechanism – your muscles have gone into spasm in order to protect against a perceived threat. So inflicting a lot of pain while you release them is counter productive.
    Here’s a link to a pain free method of trigger release: https://lifeafterpain.com/info/trigger-point/trigger-point-release-ischemic/
    And our trigger point finder: http://triggerpointmaps.com/triggercharts/landing.html where you can find the suboccipital and trapezius triggers.

    Reply

[…] are generally a section of an overworked muscle. Occasionally one feels pain when a knot is touched, it is normal that a patient will react to that […]

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[…] Life After Pain […]

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nen February 27, 2018

Hi Dr Jon
Thank you so much for sharing your valuable knowledge. It has really added to my knowledge in doing massages

Nen Sorensen

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Florence Welch May 2, 2019

It sure is helpful that you educated me about the body’s trigger points which are thickened bands of muscles that are tender to the touch. I’ve noticed that I have sore muscles in my back and on the lower part of my neck. That is why I am planning on going to a chiropractor to help relieve the pain and be able to locate other trigger points in my body. I hope that by doing this, I will be able to lessen the pain that I am experiencing.

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Stella Mary July 10, 2019

This could be the most awaited post. At times we unknowingly get into this problem. Sleeping in a bad position could be one reason and struggle for a couple of days to get normal. Thank you for sharing the post.

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[…] I also occasionally get terrible upper back pain. When I have it, I can never get comfortable and I can’t sleep for the pain. The back pain turned out to be caused by trigger points, and now when my upper back and shoulders are hurting, I can usually fix it by unlocking the trigger points in my levator scapulae or trapezius muscles. (Here’s Jonathan’s article Trigger Points for Neck Pain). […]

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Jill January 18, 2021

How can I find a doctor who really understands trigger points. I am in central new jersery.

Thank you

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