Trigger points are popularly known as muscle knots. They are actually very localised cramps in muscles where, due to a lack of blood flow and oxygen, an oversensitive area is created. From the outside, these muscle nodes can be felt as painful hard lumps or strings. When you apply considerable pressure to them, this can cause radiating pain in another part of the body. Trigger points can occur in all muscles in the body, and always in fixed places. Namely where the nervous system transmits information to the muscle. Often the cause is overexertion, stress or poor posture, but also a fall or accident, too little exercise or poor nutrition can lead to the occurrence.

The radiating area

Each trigger point has a specific pain radiating area that in many cases covers a different area than the location of the trigger point itself. A trigger point in the small buttock causes pain radiating into the ankle. And a lot of tension in the trapezius, can lead to headaches (see picture). It can also happen that your therapist treats a muscle near your shoulder blade, while you feel it in your arm. So each trigger point has a unique pain pattern that sometimes covers completely different parts of the body. Because of this knowledge, a lot of "vague" pain complaints now appear to be explainable and treatable.

Physical overexertion can cause a muscle to be stretched for a long period of time. This leads locally to a shortage of oxygen and nutrients, which further increases the contraction. In the end, a painful thickening of the muscle occurs, or a trigger point.

Psychological cause of trigger points

Can the psyche also cause trigger points? Yeah. Absolutely.  Practical experience shows that psychological factors play a major role in pain caused by trigger points. This is because trigger points occur at places where the blood circulation has decreased. Blood flow is regulated throughout the body by the autonomic nervous system that is controlled from the hypothalamus in the brain. The hypothalamus has strong connections with emotional centres in the brain, such as the amygdala.


Certain emotions (especially self-imposed pressure and repressed feelings) can cause the nervous system to cause long-term reduced blood flow in certain parts of the body. Trigger points are then the result.