Back Pain? Start by Looking Elsewhere

Posted by PHS Chiropractic on Thursday, June 25, 2015

In the vast majority of people reporting back pain, their symptoms have absolutely nothing to do with the discs or vertebrae.


Instead, their pain can be directly linked to trigger points—those tight areas of knotted or spasming muscles that can cause referred pain so severe that patients have mistaken it for a heart attack. 


In many ways, trigger point therapy sounds almost too good to be true, but it is true and it really works. For back-pain sufferers—26 million and growing in the U.S. alone—the therapy can quickly and effectively relieve pain, even chronic pain, without surgery. Here’s how: 


A Holistic Therapy


For patients with back pain—or any type of pain—trigger point therapy’s first step is to look for the factors that may have caused the problem in the first place. After all, if a patient doesn’t change what he or she is doing to cause the pain, it will never be eliminated. This means assessing many areas, including: a patient’s posture—both waking and sleeping; nutritional factors, such as dehydration; ergonomics; and any physical issues in the legs or feet, such as one leg that’s shorter than the other. 


Next, we look at the roadmap created for us by Dr. Janet Travell and Dr. David Simons, which clearly illustrates the body and how those muscles that contain trigger points can refer pain and discomfort. For example, 13 different muscles can refer pain to the lower back—and the two most important muscles aren’t even located in the back, but in the abdomen!


If the problem is related to a trigger point, we know it right away. Often when I press on a muscle that’s harboring a trigger point, I can see the light bulb go on in my patient’s eyes and they say, “Yes, that’s my pain, that’s my problem!”—because he or she is so excited that I could identify and replicate what has been bothering them.


Once we’ve identified the trigger point area that’s causing the issue, we use soft tissue tools or hands and elbows to apply pressure and relieve the problem. In some cases it only takes minutes to relieve an issue that could have been causing a patient pain for days, or even months. 


After treatment, we also teach patients how to keep the pain from returning. For lower back pain, any kind of dynamic, broad exercise program is important for overall health and postural stability. Keeping the muscles loose and relaxed when they’re not being actively used is another critically important part of maintaining healthy muscles and preventing trigger points. 


For back pain, it’s especially important to keep the abdominal muscles loose. For example, those who work at a desk all day may not even be aware of how often they are clenching their abdominals while sitting. Advise your patients to make sure they stand up and walk several times a day to help lengthen and relax those abdominals and help prevent back pain from starting.


A Different Viewpoint


Trigger point therapy means you are often looking at pain in a very different way from what you may traditionally have been taught. Instead of chasing the pain and treating what or where it hurts, trigger point therapy tells us, for example, that knee pain may be coming from the muscle at the top of the thigh, or that lower back pain may actually stem from a muscle higher up in the back. By looking at pain with this different viewpoint, we can eliminate the source—not just the symptom.


As more and more pain patients seek out nonsurgical interventions and want to avoid long-term medications, trigger point therapy is a solution. Physical therapists, massage therapists, chiropractors, athletic trainers and many other health care practitioners can take courses and include trigger point therapy in their practices. Patients can also learn about trigger points and apply self care to help manage their own pain. 



Mary Biancalana runs her own educational program for Advanced Trigger Point Education. For more information, visit

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PHS Chiropractic

In the chiropractic field, flexibility is the name of the game. It’s our mantra too. Since we launched in 2005, PHS Chiropractic has become a leader in beautifully designed, customizable chiropractic tables and accessories. We design our base tables to be feature-rich, meeting the needs of the student or new practitioner. Yet as you grow your practice, our tables grow with you: We’ve dreamed up every possible feature, from drops to elevating heights to adjustable head pieces—all easily added to your existing table to broaden your options. It’s all part of the thought and care that we put into each and every PHS Chiropractic product. Made right here in the Midwest at our plant in Watertown, South Dakota, our products reflect our strong values: high quality, integrity, creativity and innovation. The result is a rich line of chiropractic tables and accessories—from our groundbreaking Tradeflex series to our patented ErgoStyle drops—all offering a high level of design expertise, patented features and great value that give you the tools you need to build a successful practice.