Most massage therapists and myotherapists treat taut bands of muscle and what they call myofascial trigger points, or what you might know as ‘knots’ in the muscle. Also known as trigger points, they are described as hyperirritable spots in the fascia surrounding skeletal muscle. They are associated with palpable nodules in taut bands of muscle fibres. There is little science around what causes these trigger points, or how they can be medically diagnosed, as they cannot be seen in medical imaging. As a result, the misdiagnosis of myofascial pain is prevalent.
The misdiagnosis of pain is the most important issue taken up by Travell and Simons, the clinical physicians who coined the term, trigger point. Referred pain from trigger points mimics the symptoms of a very long list of common maladies, but physicians, in weighing all the possible causes for a given condition, rarely consider a myofascial source. The study of trigger points has not historically been part of medical education. Travell and Simons hold that most of the common everyday pain is caused by myofascial trigger points and that ignorance of that basic concept could inevitably lead to false diagnoses and the ultimate failure to deal effectively with pain. 
Below are just five symptoms of myofascial pain. If you’ve explored other options with your GP, with no results, consider checking with your massage therapist to see if myofascial tension could be the cause…
- Earaches, Ringing (Tinnitus) or Itchy ears
These muscles in the front of the neck, jaw and face join in around the base of the ear and can lead to ear pain, feeling of itchiness or create a ringing in the ear.
Sternocleidomastoid or SCM for short, has a whole list of symptoms it can cause when it is tight and has active trigger points, including sinusitis-like symptoms, dizziness after whiplash injury, sore throat, temple or frontal headache, dry cough and nasal drip. Tension in SCM in combination with tension in the masseter and pterygoid muscles, that help you chew, can lead to ear pain.
Massage through the front of the neck and jaw can ease these symptoms.
Rapid, Fluttery, Irregular Heartbeat or Heart Attack-like Pain
Muscles in the chest, including the sternalis and pectorial major, can cause pain in the chest. While trigger points in the scalenes, at the front of the neck can cause referral pain in the chest and arm. Tension in these muscles can lead to pain that emulates heart palpitations or heart attack. However, if you are having these symptoms, please call emergency and be cleared for any heart problems first before you think about having a massage.
- Irritable Bowel
Trigger points in the lateral abdominal obliques can cause dysfunction of the muscle and inhibit the function of the bowels.
While dysfunction of the multifidi of the lumber spine can cause dysfunction of the pelvic floor muscles that control bowel and bladder movements.
Massage to the abdomen can help get the muscles back to normal function and relieve active trigger points that may be causing pain and dysfunction.
One way to help recruit and strengthen the lumbar multifidus muscles is by tensing the pelvic floor muscles for a few seconds “as if stopping urination midstream”.
- Stress Incontinence or Anal/Genital/Perineal pain
Stress incontinence is a condition (found chiefly in women) in which there is involuntary emission of urine when pressure within the abdomen increases suddenly, as in coughing or jumping.
Stress on the adductor magnus, piriformis and pelvic floor muscles can often occur during childbirth, or exercise. These muscles are on the inside of the thigh, in the deep gluteals/hip rotators and the distal floor of the pelvis respectively.
The pelvic floor is important in providing support for pelvic organs, such as the bladder, intestines, the uterus and in maintenance of continence as part of the urinary and anal sphincters. It facilitates birth by resisting the descent of the presenting part, causing the foetus to rotate forwards to navigate through the pelvic girdle. It helps maintain optimal intra-abdominal pressure.
Massage can be performed through the adductor magnus and piriformis. Your massage or physical therapist can teach self-massage to you for the pelvic floor, stretches and exercises to help ease tension in all of these muscles.
- Menstrual or Pelvic Pain
Similarly, the muscles around the pelvic floor, deep glutes, sacrum and abdominals can cause menstrual or pelvic pain. Some abdominal massage, self massage to the pelvic floor and stretches and exercises can aid in releasing these muscles to ease menstrual pain.
Please remember, that although muscular pain can lead to a range of symptoms, to check with your GP or health physician first to rule out any other cause.