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The Art and Science of Trigger Point Treatments
Episode 3629th June 2021 • Back Talk Doc • Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates
00:00:00 00:32:36

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Sometimes imaging doesn’t explain a patient’s pain, and when that is the case, many will feel discouraged if not flat-out alarmed.

Trigger points can offer answers, and it’s the topic of this episode of Back Talk Doc.

Marty Kestin joins the podcast to explain more about trigger points and how they are involved in causing pain. At Ensoma Bodyworks, Marty teaches both patients and students how to restore and improve body functioning by the way of advanced orthopedics like neuromuscular massage therapy and neuroplasticity.

Trigger points typically come into play when MRI imaging and other avenues of identifying pain come up short. Just because the cause of pain can’t be detected through imaging, doesn’t mean the patient is faking it. Quite the opposite. As Dr. Lakhia remarks in this episode: “Your pain is real. We're going to go on the hunt to find where it's coming from.”

Listen to this episode of Back Talk Doc to understand the science behind how trigger points work, their role in causing pain, and how understanding them can lead to better pain management. 

💡 Featured Experts 💡

Name: Marty Kestin

What he does: As a Pain Detective, Marty draws on 25-years of pain management experience to not only find what is causing a patient’s pain, but to rid them of it.

Company: Ensoma Bodyworks

Words of wisdom: “My practice has been attracting recalcitrant or just stubborn enigmatic cases for about 10, 15 years now. Fortunately, they've already been to the doctor, or the chiropractor, or the PT, or the acupuncturist. Or the massage therapist. They come to me and go, ‘Nobody could figure it out.’ So they've gone through a lot of diagnostics and assessments, and I ask them, ‘How many people have examined your skeletal muscle in a microscopic way where they're combing over what they think the problematic area could be?’ Almost always, nobody's ever done that for them.”

Connect: LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★    Don’t overlook trigger point evaluation if you haven’t come up with answers for your pain.  Many doctors don’t consider trigger points when it comes to determining the cause of pain; you’ll need to see a specialist. It’s important to know that it is an option, especially if a physician cannot determine what is causing your body pain in a traditional manner.

★    There are multiple ways to treat trigger points. There is never a one size fits all approach to pain, even when the pain results from trigger points. With a host of different treatment options, it’s important to understand each treatment method and what may be best for you. Dry needling is particularly popular, but “spray and stretch” may be more comfortable for some people.

★    Other symptoms could be related to trigger points. With trigger points, it’s not uncommon for there to be other symptoms aside from pain. Abdominal trigger points can cause diarrhea or IBS, for example.

⚕️ Episode Insights ⚕️

[00:00] Mobile-based solutions for clinical practice: Check out our sponsor, QxMD, which builds mobile solutions that drive evidence-based medicine in clinical practice with over 500 easy-to-use decision support tools.

[01:50] The bodywork savant: Dr. Lakhia introduces Marty, a friend and colleague, and his work with trigger points and massage therapy.

[03:43] What is a trigger point?: Marty defines exactly what a trigger point is by explaining its history and physical representation in a person’s body.

[08:21] When to suspect a trigger point: Dr. Lakhia asks Marty what can indicate a trigger point is the cause of pain and what to look out for, and which doctors to seek out.

[11:09] A short history on imaging studies: Marty talks about imaging studies — especially in relation to trigger points and pain patterns.

[13:18] Treatment options: Dr. Lahkia brings up different options for treatment of trigger points from Travell’s method to injecting trigger points with substance. Marty offers additional suggestions, including self-treatment options.

[17:10] Classic pain patterns: With trigger points, there are classic pain patterns to know and understand, like sciatica. Dr. Lakhia and Marty explain what the most common pain patterns are and how to identify them.

[21:26] When a headache isn’t just a headache: Trigger points can, well, trigger autonomic symptoms such as headaches, vertigo, and dizziness. Marty discusses the autonomic presentations that he has seen.

[24:42] It’s not just about the back: The front of the body and its trigger points often get neglected in favor of back and spinal issues.

[26:52] Self-care in the modern age: Marty offers suggestions for how people can stay out of trouble when it comes to trigger points.

[28:42] How Marty thrives personally and professionally: Marty breaks down what keeps him going, not only as a clinician but as a human being.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Should You Be Concerned About Seeing a Physician Assistant for Spine Care?

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit

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Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at




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