Why Do I Get Myofascial Trigger Points? Part Three
We do not know exactly why myofascial trigger points occur and there are many theories about how and why they form. In Part One, we examined a couple of muscle-based theories. In Part Two we explored theories involving the fascia and nerve networks. Now in Part Three, we will take another look at the Overstimulated Nerves hypothesis, or central sensitization. We will discuss how sleep and stress can lead to myofascial pain and why addressing these factors is essential in resolving it. If you missed Part Two, it may be helpful to review the Overstimulated Nerves hypothesis before continuing.
Sleep dysfunction
Sleep is vital for our well-being, and recent findings reveal a significant link between poor sleep and increased pain sensitivity. In a notable study, researchers observed
gender differences in response to disrupted sleep. Using capsaicin, an extract from hot peppers, they tested participants’ ability to detect where it was applied to the skin. Men with poor sleep showed a broader sensitivity to pain signals, extending beyond the area where capsaicin was applied. In another test, pressure was applied repeatedly to the skin with a rubber probe. Women with disturbed sleep showed that repeatedly touching the skin with the probe caused that pressure to feel increasingly painful.
This isn't merely about discomfort; it's about understanding the pivotal role sleep plays in pain management. Your sleep quality impacts more than just how tired you feel; it directly affects your pain experience. If you’re struggling with sleep, it could mean you are experiencing more pain than necessary.
Chronic stress
Research also suggests that stress influences the nervous system, by closely interacting with the immune system. Just as hypersensitive nerves trigger inflammation in the area of myofascial trigger points, stress can activate this process, leading to a cycle of heightened nerve sensitivity and inflammation. Chronic pain conditions often arise from ongoing stress, which perpetually activates the “fight-or-flight” response of the sympathetic nervous system. This continuous activation lowers the brain and spinal cord’s pain response threshold, making us more sensitive to pain and more reactive to areas signaling muscle injury.
On the brighter side, leveraging the power of the vagus nerve, a key component of the parasympathetic nervous system, has shown promise in reducing inflammation and managing chronic pain conditions such as fibromyalgia, chronic pelvic pain, and headache. Studies using non-invasive vagal nerve stimulators have shown decreased inflammation and pain sensitivity in various chronic pain conditions. This supports the idea that these conditions are related to a constant “fight-or-flight” state.
While our understanding of myofascial trigger points continues to evolve, it's evident that a complex interplay of physical and nerve-related factors contributes to myofascial pain. In future blogs, we'll explore how our knowledge of hypersensitive nerves can aid in pain management. Meanwhile, prioritize your sleep and minimize stressors for a healthier, pain-free life.
References:
Smith M. Sex differences in measures of central sensitization and pain sensitivity to experimental sleep disruption: implications for sex differences in chronic pain Sleep. 2019, 42 (2):209. https://doi.org/10.1093/sleep/zsy209.
Meade, E.; Garvey, M. The Role of Neuro-Immune Interaction in Chronic Pain Conditions; Functional Somatic Syndrome, Neurogenic Inflammation, and Peripheral Neuropathy. Int. J. Mol. Sci. 2022, 23 (15):8574. https://doi.org/10.3390/ijms23158574.
Chakravarthy, K. Chaudhry, H. Review of the Uses of Vagal Nerve Stimulation in Chronic Pain Management Curr Pain Headache Rep 2015.19:54. DOI 10.1007/s11916-015-0528-6
