What Trigger Points Are and Why They Keep Coming Back

You know that spot.

The one in your shoulder that feels like a tiny pebble under the skin.
The one at the base of your skull that turns into a headache by late afternoon.
The knot in your upper back that seems to return the day after it finally softens.

Those are often what we call trigger points – small, tight areas in your muscles that can create a surprisingly big amount of discomfort. They can make your body feel achy, tense, and strangely tired, even if your day was not especially physical.

If you are in Toronto and feel like you are always chasing the same few knots, this gentle guide will walk you through what trigger points are, why they tend to come back, and how massage and simple daily habits may help them settle over time.

What trigger points actually are

Trigger points are often described as tiny “knots” in a muscle, but there is more going on than just a tight spot.

In simple terms, a trigger point is:

• A small, very sensitive spot in a muscle
• Sitting inside a slightly tighter band of muscle fibres
• That can feel sore when touched and may send pain somewhere else

In research and clinical writing, myofascial trigger points are defined as hyper-irritable spots in a palpable taut band of skeletal muscle that can cause local and referred pain. NCBI Physiopedia

You might notice:

• A small, tender nodule when you press on the area
• Pain that spreads (for example, from the top of the shoulder into the neck or head)
• A sense of “tight but tired” in the surrounding muscle
• Mild weakness or stiffness when you try to use that muscle fully

Trigger points often appear in places that work hard to hold you up throughout the day, such as the upper trapezius (tops of the shoulders), neck muscles, low back, and hips. Studies suggest that myofascial trigger points are very common in people with neck, back, and other persistent musculoskeletal pain. ScienceDirect Nature MDPI

What is happening inside the muscle?

Researchers are still exploring the exact science, but one leading idea is sometimes called the “integrated hypothesis.” In everyday language, it looks like this: Physiopedia Sciencedirect PM&R KnowledgeNow

1. A small cluster of muscle fibres stays slightly contracted instead of relaxing.
2. That tight area can squeeze local blood flow.
3. With less fresh blood, the area may not get enough oxygen and energy.
4. Waste products and chemical irritants build up around local nerve endings.
5. Those irritated nerves send pain signals, and the nervous system may become more sensitive to that area over time.

So the “knot” you feel is not just mechanical tightness. It is also a small, sensitive ecosystem in the muscle that is asking for attention and relief.

Why trigger points keep coming back

If you feel like your trigger points are on a loop, you are not imagining it. There are a few reasons they can be stubborn.

1. Repeated strain and static posture

Trigger points often form in muscles that are asked to do the same thing, over and over, without enough rest or variety.

That might look like:

• Hunched working over a laptop most of the day
• Holding your phone in the same position
• Standing for long periods with your weight shifted to one leg
• Repetitive tasks at work or in the gym

These patterns can keep certain muscles slightly “on” all the time. Over weeks or months, that ongoing low-level strain can help trigger points form and stay active. AAFP Sciencedirect

2. Stress and your nervous system

Stress is not only in your thoughts. Your nervous system influences how tightly your muscles hold themselves. When you are under ongoing stress, your body may stay closer to a “ready to react” state.

In that state, muscles in your shoulders, neck, jaw, and back can hold extra tension. This can:

• Make existing trigger points more sensitive
• Lower the threshold for new trigger points to form
• Make you more aware of pain signals that were easier to ignore before

3. The pain–tension loop

Pain and tension can feed each other.

• A trigger point hurts, so the surrounding muscles tighten to “protect” the area.
• That extra tightness restricts movement and blood flow even more.
• The trigger point becomes more irritated, and your nervous system may become more sensitive to that region.

Without enough chances to move differently, relax, and feel safe, this loop can keep going, which is one reason trigger points can keep returning to the same places. ASRA Pain Medicine Academy of Osteopathy

4. Lack of movement variety

You do not need intense workouts to support your muscles. What they often need is variety.

When your day is mostly:

• Sitting
• Short, rushed walks
• Phone scrolling with your head forward

Your muscles do not get frequent, gentle chances to lengthen, shorten, and circulate fresh blood. Trigger points may ease after a massage, then slowly flare again if the daily movement pattern that contributed to them has not changed.

5. Underlying pain conditions

For some people, myofascial pain and trigger points show up alongside other persistent pain conditions. In these cases, the nervous system may already be more sensitive, and trigger points can be one piece of a more complex picture. ScienceDirect

If that sounds like you, it does not mean you cannot feel better. It just means your body may need a gentle, patient, multi-layered approach over time.

How massage can help with trigger points

Massage is not a magic eraser, but for many people it can be a helpful part of easing myofascial pain and softening trigger points.

Research suggests that manual therapies such as massage, physical therapy, and other hands-on approaches can reduce pain, improve function, and help deactivate trigger points, especially when they are part of a broader care plan. JAMA Network ScienceDirect JOSPT Bodywork Movement Therapies AAFP MDPI

What I focus on in session

During a session for trigger point related discomfort, we might:

• Locate and listen
  Gently palpating the muscles to find tender nodules and taut bands, while checking in with you about your pain levels and sensations.
• Use slow, sustained pressure
  Applying steady, tolerable pressure over a trigger point can help the area receive more blood flow, reduce local irritation, and send calmer messages to the nervous system.
• Work with the whole area, not just the “knot”
  Often the muscle above or below the tender spot is involved too. We might work along a chain of muscles in your neck, upper back, or hips to help the whole region relax.
• Support your breathing and relaxation
  Slow, easy breathing helps your nervous system shift toward a more restful state. That calmer state can make it easier for muscles to let go.
• Respect your limits
  Trigger point work does not need to be aggressive to be effective. The goal is “good pressure” that feels productive, not painful or alarming.

Over time, regular sessions can help:

• Reduce the intensity and frequency of specific trigger points
• Improve your sense of ease and range of motion
• Make your body feel less “on guard” all the time

Massage is usually most helpful when paired with gentle changes in how you move, rest, and support your body between sessions.

Simple things you can try between sessions

These ideas are meant to be gentle, low-risk options for many people. They are not a replacement for medical advice, especially if your pain is severe, unusual, or worsening.

1. Gentle movement breaks

Every 30–60 minutes, invite a small reset:

• Slowly roll your shoulders a few times
• Turn your head side to side within a comfortable range
• Stand up, shift your weight, and take a short walk down the hall

These simple movements can help circulation and reduce the load on the same few muscles. Clinical guidance for myofascial pain often includes a combination of manual therapy and stretching or gentle exercise to maintain gains. NCBI

2. Warmth for comfort

A warm shower, a heating pad on a low setting, or a warm towel can:

• Encourage local blood flow
• Help muscles feel more receptive to stretching or gentle self-massage
• Provide a soothing sensory cue to your nervous system

Avoid strong heat on areas of reduced sensation or active inflammation, and always protect your skin.

3. Soft self-massage

If it feels safe and comfortable, you can:

• Use your fingertips to gently explore a tight area
• Apply slow, steady pressure for 20–30 seconds, then release
• Or lean gently into a soft ball against the wall, moving slowly until you find a tolerable pressure point

Keep your breathing slow and easy. Stop if you feel sharp pain, numbness, or anything that worries you.

4. Small posture and setup tweaks

You do not need perfect posture. You just need less strain. You might experiment with:

• Bringing your screen closer to eye level
• Using a small pillow behind your low back
• Alternating which leg you cross, or keeping both feet on the floor for periods
• Bringing your phone up toward your face rather than dropping your head far forward

Even small changes can reduce repeated strain on the same trigger point-prone areas.

5. Support for stress

Since trigger points and stress often interact, anything that helps your nervous system feel safer can be part of your pain care:

• Gentle breathing practices
• Time in nature
• Short, regular breaks instead of pushing until you crash
• Support from a therapist, support group, or trusted person when emotions feel heavy

None of these are “quick fixes”, but together they create a kinder environment for your muscles and your nervous system.

When to reach out for extra support

Please check in with your primary healthcare provider if you notice:

• Sudden, severe pain that feels different from your usual patterns
• Pain with significant weakness, numbness, or tingling
• Unexplained weight loss, fever, or other systemic symptoms
• Persistent pain that is not improving with rest and gentle care

Trigger points are very common in people with musculoskeletal pain, but they are only one potential contributor. A full assessment can help rule out other concerns and make sure you are getting the right type of support. AAFP PM&R KnowledgeNow

If you are tired of chasing the same knots

If you are in Toronto and feel like the same trigger points keep coming back, you do not have to figure it out alone.

In a massage session, we can:

• Map out your main areas of tension
• Explore how your daily habits may be affecting your muscles
• Use gentle, focused techniques to calm trigger points and support your nervous system
• Create a simple, realistic plan you can carry into your week

You deserve a body that feels a little softer and more supported.
If you feel ready, you are always welcome to book a session so we can explore this together.