Trigger Point Therapy Resources for Back Pain

I use trigger point therapy for my back pain every day. You can skip to my page about how to try it yourself at home, or you can read on for a detailed description of the technique and resources available.

Trigger point therapy, also known as myofascial release or myotherapy for short, is such a big part of natural pain relief that I'm amazed so few people have heard of it, despite the fact that more than half a century has passed since Dr. Janet Travell "discovered" trigger points. Although it is often considered a modality of massage, it doesn't feel particularly good to receive, so perhaps that's why so few massage therapists are trained in it. Yet the therapy is effective, it's non-invasive when used at home (though medical professionals sometimes use injections), and it's not too difficult to use the technique on yourself once you get the trick of it.

Trigger points are real. I frequently massage mine to ease acute attacks of my chronic muscular pain in my back. After treating myself, I've had the pain relief last for hours, days, weeks, months, or even years, depending on the part of the body I'm working, how severe the trigger points are and how much insult they get. If a few applications don't fix the pain, then I go on for longer until the pain is gone. Usually that's no more than a few days for one set of related trigger points.

The idea behind self-treatment using trigger point therapy is pretty simple: to find and release, through massage, the places in your muscles that are knotted. This is necessary because those muscle knots are keeping the muscles from being able to do their job of stretching and contracting. In other words, the muscles are malfunctioning, and releasing the trigger points can allow the muscles to recover their function.

It's not quite as easy as it sounds, however, especially when you're trying to fix your back.

The first challenge is that the back is a complicated place, with some muscles, like the gluteal muscles, easily accessible, while others, like the iliopsoas and the piriformis, are quite deeply hidden and virtually inaccessible. Not only must you find which of these muscles are affected by trigger points, but then you must find the trigger points, themselves.

Most of those points are not obvious. Trigger points are knots in the muscles that hurt when touched, but trigger points are not located WHERE it hurts. Oddly, trigger points are not located randomly on the muscles, either. They are located in certain fixed spots. Their location does not vary much from person to person.

I have been doing trigger point therapy for so many years that I now find I can guess where trigger points are likely to be, and I know how to feel along the muscles to find them. But anyone starting out will need some help.

There are various diagrams and guides for how to find the locations of trigger points. Because there are so many trigger points spread out amongst the over 650 skeletal muscles in the human body, no one diagram can capture them all. One of the best quick visual guides I actually came across in our dentist's office, of all places. It is a product called the Travell and Simon's Trigger Point Flip Chart. I flipped through it and found it helpful and clearly drawn and labeled.

Begin With the Trigger Point "Bible"

Over the last twenty plus years, I have bought and read at least half a dozen books on trigger point therapy, starting with Bonnie Pruden's Pain Erasure, which I checked out from the medical research library where I worked.

Each book was helpful, but none of them managed to explain an easy way to find and work each and every trigger point the way my current "bible" of trigger points does. And none has illustrations I like as well, unless it's the definitive, very expensive, and very technical 2-volume work by Travell and Simons.

The book I consider the most authoritative for the layperson was written by a man who rediscovered Janet Travell's work, fixed his frozen shoulder using its principles, then set about making trigger point therapy accessible both to massage therapists and laypeople. He is, I am sad to say, now gone, but his daughter, who co-wrote the book, continues to work on revisions of the book.

This book helped me through plantar fasciitis, back pain, and more.

I read that book from cover to cover, going through it to find all the trigger points in my body I possibly could. Reading it and applying the techniques made a huge difference to my pain level. It meant that when I experienced pain in my leg or back while exercising, I could stop, apply trigger point therapy until the pain went away, and then continue exercising without causing injury to myself.

To get started with trigger point therapy, I recommend you start by getting the book I mentioned above, The Trigger Point Therapy Workbook by Clair Davies and his daughter, Amber Davies. I have both the second edition and the third edition, which I recently bought. I've used my beloved second edition copy till it's dog-eared with notes written on many pages.

Besides the fact that it helped me, these are some of the specific reasons I like this book and promote it here:

• It features great line illustrations that used the author as a model rather than a muscle-bound idealized human.
• It has detailed explanations of how to figure out which muscles have the trigger points. I need that verbal road map to find some of the more difficult ones.
• It has diagrams of almost all the trigger points discussed and clearly says "not shown" when they're not illustrated, which saves me much frustration.
• It is very detailed, much more so than any book of its kind that I've found.
• It's easy to use as a reference when you need it. Finding just the right place is easy because of a good index and a generally well-organized text.

Take the time to read through it. If you have muscle pain, the chances are good it will help you.

Trigger Point Massage Tools

I don't go strictly by the book. I have modified my trigger point release technique for myself. I find that for very bad trigger points, using a lot more pressure than advised, and just pressing down instead of massaging, helps the most. I also find that I get tired working my trigger points and appreciate help in the form of electric massage tools.

There are a few massage tools that help me focus on some of the harder-to-get deep trigger points.They allow me to self-treat when I would otherwise need assistance, by helping me reach the areas I need to with enough leverage.

Over the years, I have tried LOTS of massage tools. I have only found a few that are powerful, targeted and affordable enough to really help me with trigger point therapy at home. None of them is "the one" and can get at all of my trigger points on its own. But together, I'm covered.

Here are the ones I use:

Body Back Buddy

I've had my Body Back Buddy for almost five years now. This tool is so intuitively obvious, I often wonder why everybody doesn't own one. It's made of hard, durable plastic. I use this most often for my upper back and especially the area around my shoulder blades. But it can pretty much reach most places on your body. It's hard to see in the picture, but if you look closely, you'll see there are two kinds of points - a round one for more even pressure at odd angles and a tapered point for really digging in. To be effective, the tapered point has to be held at a 90 degree angle to the trigger point. The round point isn't so restrictive.

Wooden Dowel Massage Tool

I picked up this wooden dowel massage tool at a massage store at least twenty years ago, along with two larger ones as part of the set. I use it when I need to work very small trigger points in muscles of my arms, hands, and face.

Brookstone Single-Head Massager

This is a relatively new battery-operated trigger point massager I've used for about nine months. It is easy to hold, wireless and rechargeable, has a targeted single head, and really strong massage pressure. It also doesn't vibrate the holding hand too much, which is important for me as I suffer from carpal tunnel syndrome. It holds a charge for way longer than I need it to - at least an hour in my experience. I use it several times a week.


If they ever come out with a new version, I'd wish for one with a slightly pointier head, or interchangeable heads. The head it comes with is permanently affixed and works well for trigger points on larger muscles like the quads, hams, and glutes.

One disadvantage to the Brookstone is its lack of reach - it cannot be used on my upper back unless someone else holds it there.

But it can be taken in the car. That is huge.

Thumper Mini Pro 2 Massager

The Thumper Mini Pro 2 is my favorite electric massager for the trigger points on my back. I use it mostly on my quadriceps, hamstrings, calves, gluteal muscles, the muscles deep in my waist (a real problem for people with spondy), and the deep muscles in the buttocks like the piriformis.

It is powerful, well built, and because of the handle design has great reach for any place on the body. It was deliberately designed to cause virtually no hand-shock from the percussion. It's good for about 20 minutes of extremely powerful massage before it gets too warm and needs to cool down. I've invested in two of them for when one is in use.

As for cons, I would prefer it if it were single-headed, which would make it easier to leverage against some awkward trigger points. The company does make a one-headed model, the Thumper VMTX single head, with interchangeable heads, one of which appears to be pointy enough for trigger points. I do not own it yet. It seems similar to the Brookstone model described above, but it also has a wrist band to help with leverage. It does lack the long handle of the Mini Pro 2, unfortunately.

To get rid of trigger points, I use the Mini Pro 2 at its highest setting and focus on a tender area for several seconds, often canting the tool so only one of the heads is in contact with the trigger point. Then I move it around and later come back to the area. Working out trigger points with this tool sometimes makes them itch for a short while. My massage therapist mother-in-law tells me this is a sign that the muscle knot is releasing.

Wahl Deep Tissue Percussion Massager

My Wahl deep tissue massager is not nearly as powerful as the Thumper or the Brookstone. But it has two advantages: It's lighter to hold AND it has a head that's very pointy called the accupoint attachment, as you can see from the picture.

The pointy attachment is perfect for getting deep trigger points that are hard to reach or too near the bone for the Thumper Mini Pro 2 to safely handle, such as the difficult quadratus lumborum or the piriformis.

Try Trigger Point Therapy - You'll Sort of Like It

When you start trigger point therapy for your back, don't expect it to feel nice and soothing. I do wish I could tell you that, but the bald truth is that it hurts. 

Here is what you can expect:

• Working the trigger points will hurt, but it should be a "good hurt." It should not be excruciating or make you feel dizzy or weird. If it does, you need to step back, check the book for important safety tips, and re-evaluate.
• After trying trigger point therapy for a couple of days, you should start to notice some benefit. The pain should lessen at least a little bit, or your range of motion should be a tiny bit better. If you do not see any benefit yet, then based on my experience, I'd guess that either your technique needs work, or myotherapy is simply not helpful in your case.

When people have lots of trigger points, it's called myofascial pain syndrome. But not everyone with trigger points "has" MPS.  Pretty much everyone I've tried to help with trigger point therapy - including friends and family - has noticed significant improvements in their pain levels.