Your chronic pain may be caused by tender spots (represented by the black dots) in muscles, tendons, and ligaments known as myofascial trigger points. Trigger points commonly called "muscle knots" cause local pain and stiffness, as well as create referral pain (indicated in red) in other areas of your body.

Trigger points cause pain in one region e.g. recurrent back pain or shoulder-arm pain after a game of golf or yard work or it can become generalized throughout your body (fibromyalgia) causing chronic pain and fatigue for years.

The respected pain researchers Melzack and Wall (1988) have reported in their studies that myofascial trigger points are key elements in all chronic pain. Furthermore, they found that myofascial trigger points are often the main factor in maintaining your chronic pain. Properly applied pressure massage, or trigger point therapy, can deactivate these trigger points. (See interview questions 5 - 14.)

	Muscle trauma, from motor vehicle accidents, slip / fall injuries, sport and work related injuries, etc.
	Muscle strain, from repetitive movements at work or at play
	Postural strain, from long term standing or sitting improperly (e.g. computer keyboard work)
	Emotional stress causing anxiety and muscle tension. (See interview Section XIV.)
	As well as allergies, environmental toxicity and nutritional deficiencies. (See interview Section XII for role of Environmental Toxicity.) (See interview Section XIII for role of Nutritional Deficiency.)

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