To make progress with pain, start calling it "strong, unpleasant sensations". Your words have emotional power.
That word "pain" carries a lot of emotional baggage. Choosing to think "that's a really strong sensation and I don't like it" takes some power away from it right away. Then we start calming the body and calming the brain. It's important to understand that pain isn't "all in your head"; it is also in your spinal cord. When pain has become chronic, lasting over three months at unpleasant levels, the nerves that carry pain signals will have started doing that better. It's like they're yelling at you "HEY! DO SOMETHING ABOUT THIS INJURY!!! - but then, you might not know exactly what to do. The brain also will have become more sensitive and more reactive to pain signals. All this is called "central sensitization". That process needs to be reversed. To do that we'll show you how to reduce the effects of trigger points. We'll do muscle tension biofeedback and home muscle relaxation exercises. We'll use biofeedback and often neurofeedback to calm the brain down. We'll encourage you to eat right and start getting regular exercise.
Myofascial pain and trigger points
Muscles, ligaments and their coverings can become sore and irritated from chronic use or overuse. This condition, sometimes called Myofascial Pain Syndrome (MPS), often occurs in persons who perform repetitive tasks — typing, data entry, or other frequent use of keyboards. Muscle can be newly "triggered" from accidents, and sometimes just from chronic tension. Think of triggered areas as "stuck spots" which must be loosened up.
Trigger points not only hurt where they are — they "refer" pain to different areas, sometimes pretty far from where the trigger point is. Motor vehicle accidents and falls, particularly when "whiplash" type injuries occur, are major sources of triggered muscle.
A simple method for controlling trigger points
The basic steps in trigger point release:
- Recognize the problem. Going home from work with sore arms should not be accepted as simply "part of the territory."
- Decide to do something about it. This means committing yourself to altering some routines and habits.
- Compress the trigger points. Press on the sore spots in your muscles, beginning at the joint and working down along the whole length of the muscle. Press each sore area for 10 - 15 seconds, holding the pressure steady at a level that feel like you're doing something, but not hurting yourself. Sometimes people say it "hurts good" when they've got just the right amount of pressure. For trigger points in the back muscles, consider a Backnobber or TheraCane, available in some drugstores and online.
- Stretch the muscles. Follow trigger point compression with slow, deep stretching. Breathe out as you stretch a little further, but don't over-stretch. Easy does it.
If this procedure makes you worse the next day — you're doing it too hard.
This procedure is called "myofascial trigger point release" and is commonly used by sports medicine physical therapists. It will not give permanent relief unless done regularly. The method of correcting trigger points was first described by Janet Travell, M.D. and David Simons, MD, and later taken to a highly developed treatment process called "myotherapy" by Bonnie Prudden, which she described in detail in her book Pain Erasure.
Noticing tension — and learning to release it
Treating trigger points is necessary, but it isn't sufficient on its own. If you compress and stretch a sore muscle in the morning and then spend the rest of the day hunched over a keyboard, jaw clenched, shoulders riding up toward your ears, you are rebuilding the problem as fast as you're clearing it. The trigger points will keep coming back. Progress requires two things working together: treating the trigger points when they're there, and learning to notice and reduce the background tension that keeps recreating them.
Most people with chronic pain have been carrying unnecessary tension for so long that it has become invisible to them — it simply feels like normal. The first skill to develop is noticing. Can you feel the difference between your right shoulder and your left, right now? Is your jaw clenched? Are you holding your breath slightly? These small habitual contractions, sustained hour after hour, are significant. Pain postures — the way we unconsciously protect a sore area by guarding it, shifting weight, rounding the spine — add their own layer of tension on top of the original problem.
Progressive Muscle Relaxation (PMR) is one of the most effective methods for developing this awareness. By deliberately tensing one muscle group at a time — just enough to feel it clearly — and then switching it off, you train yourself to notice the difference between tension and release. Over time, you start catching unnecessary tension earlier, before it accumulates into pain. This is not a passive relaxation exercise. It is an active skill, and like any skill it gets better with practice.
Progressive Muscle Relaxation — guided recording by Dr. Nash
Particularly useful for chronic pain — practice daily for best results. Free to download.
▶ Download the guided PMR recording (21.8 MB)Once you're feeling less pain, it is very important to develop a habit of regular exercise. Muscles that have been triggered and painful for a long time are weak. Strength training and aerobic conditioning are essential to staying more pain-free and healthy.