Myofascial Pain
Trigger points - physiotherapy and deep tissue release

Physiotherapy defines myofascial pain, or trigger points, as very focused hyperirritability in muscles and fascia (a connective tissue) that when stimulated, can cause central nervous system modulation. They are characterized by focal tenderness, that can be widespread when palpated.

Qualities of trigger points

There are four (4) sub-types of trigger points we manage in our physiotherapy clinics:

  1. Active Trigger Points – actively referring pain locally or to another location.
  2. Latent Trigger Points – inactive trigger point that doesn’t yet refer pain, but may be activated when triggered by certain stimuli.
  3. Key Trigger Points – the stimulating trigger point that activates other latent trigger points.
  4. Satellite Trigger Points – the trigger point that is activated by the key trigger point.

Treating the primary or key trigger points do not treat the secondary satellite ones, which must be treated separately.

Potential Causes Of Trigger Points

Development or activation of trigger points can be caused by several factors, which includes muscle overloading, activation by other trigger points, disease, psychological stress, trauma, and imbalance in the human system.

They form only in the muscles and/or connective tissues such as fascia. They are a bundle of muscle fibers which can cause deep pain within muscles and joints when they pull the associated muscles. When our muscle fibers contract, it creates a byproduct of lactic acid, which the body will remove via natural circulation. In a trigger point, the tightened muscle fibres contract and this constricts localized capillaries, effectively storing the lactic acid in the bundles itself.

When trigger points become active in the muscles, there is very often weakness plus pain in the affected areas; this pain patterns have a specific neural pathway, which can be traced easily. However, because there are many trigger points that have pain patterns that overlap, the treatment of the trigger points often becomes very extensive to remove them, though our physiotherapy clients often report a sense of general wellbeing after each session of trigger point management.

Diagnosing Trigger Points

We diagnose them by clinical interviews to identify signs, followed by a physical examination of the signs, symptoms, pain patterns as well as using manual clinical palpations. For a trained physiotherapist, we can detect the taut bands and nodules within muscle fibers that causes a “all or nothing at all” twitch response – this is a primary sign. Pressing on the nodule will then cause localized or referred pain.

Some larger muscles such as the back and gluteal muscles have multiple trigger points.

Physiotherapy Treatment Of Myofascial Pain Trigger Points

  1. Myotherapy (deep pressure)
  2. Clinical Massage Therapy
  3. Mechanical Oscillation And Vibration
  4. Pulse Ultrasound
  5. Ischemic Compression
  6. Spray And Stretch
  7. Physiotherapy Stretching Techniques

Successful Physiotherapy Myofascial Pain Treatment Protocol

Includes identifying accurately the trigger points, and the execution and resolution of all the active and key trigger points. The muscles that contains inactive, latent ones need to be stretched and mobilized, as well as to mobilize the fascia of nearby structures.

The results of any manual therapy is directly related to the skill and experience level of the physiotherapist or hand therapist. If trigger points are pressed for too short time, they main be active still; if they are pressed too hard or too long, the trigger points becomes inflamed and bruised, causing longer pain in the area. This bruising may feel like the soreness related to post-exercise soreness, but it is not.

Should you do self-treatments for your myofascial pain?

Some patients wants to administer their own self-treatments in between physiotherapy sessions, as they want immediate relief. It is possible, and we can train you in managing the symptomatic relief of pain – you’d need to have fair working knowledge of the anatomy and physiology of your affected areas, and understand the risks. We also have trigger balls and foam rollers that can help reach those hard-to-reach knots available in our clinics.

The risks includes possible damage of soft tissues and other organs (e.g. too close to nerve bundles, organs such as kidneys (for the treatment of trigger point in the quadratus lumborum) or the underlying glands.

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Our Physio & Rehab Expertise

Phoenix Rehab Group works with specialist physiotherapists and specialist rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.

Areas of specialization

  • physiotherapy: back and neck (spine), sports, shoulder, hip, knee, ankle
  • hand therapy: forearm, wrist, hand and fingers
  • podiatrist: leg, calf, ankle, foot and toes
  • read more on our specializations here

All our therapists are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCM). See our entire team here by location and specialization.

Initially, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover. They then provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

To call for inquiries or appointments, please contact us at:



Where to next?

  1. Make A Physiotherapy, Hand Therapy or Deep Tissue Release Singapore Appointment
  2. Arrange A CallBack or Make An E-Enquiry Here
  3. See the list of physiotherapy conditions we treat 
  4. See the list of orthopedic surgeons we serve in Singapore
  5. Return to Urbanrehab's Physiotherapy, Hand Therapy and Sports Massage Singapore Home Page from our myofascial pain page

Tell A Friend About Us

We appreciate you as a patient and want you to know that the #1 way we grow as a clinic is through word of mouth referrals from valued patients like yourself.

We do not rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients.

When you have the opportunity, please take the time to tell your family, friends and physicians about the positive results and experience you have had in our clinic.

Thank you so much, and stay healthy!

Please Call/SMS/WhatsApp to
+6588001830, thanks!


We are a wholly Singapore Private Limited group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations.

As listed in our website are the list of services we provide our clients as referred by their medical doctors or by self referrals/word of mouth, but you can also make an appointment without seeing any doctors (that being said, if you do need a referral to a specialist orthopedic surgeon or sports GP, we will recommend you too as value added service at no additional costs to you).

The range of rehabilitation results vary from patients to patients, depending on a variety of factors and reasons such as severity of condition, genetics, gender and age. However, we will still deliver the best evidence-based-practice of physiotherapy, hand therapy, TCM, sports training and deep tissue release therapy that we can deliver (we are proud to say that we try our best to only engage the most experienced and specialist therapists - which makes a big difference in clinical outcomes).

The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy and occupational therapy, please schedule an appointment with us by contacting our staff by Call/SMS/WhatsApp at +6588001830 or email, thanks!

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Physio, Rehab &  Insurance

Your physio, hand therapy and rehab with us may be covered under your medical insurance or cashless - find out more here.


Acupuncture TCM
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Thermal Physiotherapy
Traction Back Physiotherapy
Trigger Point Physiotherapy
Ultrasound Physiotherapy
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Finally I know what I have, my pain decreased and now I'm back to work!

Regional Sales Manager

OMG. The pain levels in my hands have dropped dramatically, about 60-70%


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