Myofascial pain trigger points
nerve root pain satellite trigger points

The first possible recognition of Trigger points may have been an offshoot of acupuncture's study of meridians and acupoints.

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In the seventh century, during the Tang Dynasty (618 AD – 907 AD) a renowned physician by the name of Sun Ssu-Miao wrote a textbook (Thousand Golden Prescriptions) which actually described a different type of point. These were not fixed in position along recognized meridians as are acupoints, but appeared on the body if disease or injury occurred. They were points which became spontaneously tender, and were detected by palpation when the troublesome part of the body was examined. When the physician pressed on the point, the patient would cry out ‘aah shi!’ meaning ‘ah yes’. These are still referred to as ah-shi points, or ‘points of pain’

‘Ah-shi’ may be described as any local tender points to be found in the area of pain that give a reaction when stimulated but which are not recognized acupoints on any actual meridian.

Sir Thomas Lewis, director of clinical research at University College Hospital, London found an interesting phenomenon when he was working on an artificial method of producing muscle pain. He found that injections of saline into muscle produced quite intense pain. Not only that, however, but the pain often extended or radiated a considerable distance from the site of the injection. For example, a saline injection in the triceps muscle often produced pain all the way down into the little finger. Similarly, an injection in the trapezius muscle often produced an occipital headache. The triceps muscle links to the tip of the baby finger along the small intestine meridian. The trapezius muscle links to the back of the head along the bladder meridian. It was a short step from this to find that certain points were particularly tender in painful conditions with a wide area of pain. When these points were injected with local anaesthetic, the pain in the wider area could be made to disappear.

Now Saline injections are being used to reduce pain and breakup the scar tissue associated with trigger points. Epidural injections of saline are being investigated for breaking up scar tissue. One 2001 study compared targeted injections of saline and steroids directed at the nerve root. Although steroid injections had more immediate benefits, both offered improvement, and by three months, patients who had saline injections experienced less pain than the steroid group.

This phenomenon is the effect of trigger points radiating to other points along the relative meridians.

Trigger point therapy is one of the largest and fastest growing muscle therapies today. Janet Travell, M.D., the White House physician under former President John F. Kennedy, and Dr. David Simons initially coined the phrase "trigger point therapy" to describe their then cutting edge treatments to resolve trouble spots. Travell used these techniques to treat JFK’s back pain. In the 1970’s Bonnie Prudden advanced Travell and Simons’ methods by developing a system of non-invasive techniques, which are widely used today by professional athletes, massage and physical therapists, and prescribed and recommended by medical doctors.

Although others had used manual methods on these points before, Travell predominantly used injections of pain medication or cold spray-and-stretch techniques. Raymond Nimmo, D.C., a chiropractor from Granby, Texas, during the same period of Travell, used receptor tonus technique, similar to the manual methods used today, to release these hypertonic areas.

Paul St. John, a subject at one of Nimmo's seminars, was so impressed with the results on his own problems that he went to massage school in order to be able to explore this healing method for himself. He is responsible in large part for bringing NMT into the world of massage therapists, beginning classes in 1979 that continue to this day. Judith Walker Delany started studying with St. John in 1983, and was active in organizing his teaching program. In 1989 she separated herself from St. John’s organization to start her own, where she was able to apply her own thoughts on how to best organize adult-learning methods.

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