A myofascial trigger point is defined as "a hyperirritable spot, usually within a taut band of skeletal muscle or in the muscle fascia, that is painful on compression and that can give rise to characteristic referred pain, tendereness, and autonomic phenomena"(1).

Martha, aged forty-eight, had been told she had epicondylitis in both elbows from repetitive strain. The pain had become so bad that she was unable to work and had to quit her job. Worry about the future kept her from sleeping. She felt worn out and tense all the time. She'd gotten many conflicting recommendations regarding treatment, ranging from extended rest to various types of reconstructive surgery. Workman's compensation would pay for almost anything she needed. She'd gone go physical therapy for months and she wore braces on her elbows most of the time, but progress had been negligible. Now her doctor wanted to put her arms in casts to immobilize them. After being shown how to massage her forearm muscles with a tennis ball, Martha was able to get rid of most of her pain in just three weeks(3).

Brian, an electrician aged 42, had pain in at the side of his right elbow. His hand had poor grip strength, and twisting a screwdriver made the pain in his elbow excruciating. He wondered if he would be able to hold down his job. Upon recommendation from a friend, Brian paid a visit to Mr. Chin, a local Chinese massage therapist. The massage felt brutal: Mr Chin seemed hell bent on finding painful spots located in Brian's forearm and squeezing them with what seemed like vice like intensity. Brian was assured that the force being used was not that hard, but he did not believe it. After sweating it out for half hour, Brian's arm was aching, but freer in its movement. The next day, the pain in Brian's elbow had markedly reduced, and he has been almost pain free and certainly happy in his work ever since. Says Brian: "the agony was worth it".