Trigger points as a neurological phenomenon. Image 1 shows the trigger point (X) initiating pain (red) and undergoing modulation (purple) at its spinal junction (a), in the brainstem (b), and in the brain (c). Repeated stimulation, as in repetitive stress injuries, result in the illusion that is referred pain (blue). Images 2 and 3 show the initial injury and its resulting referred pain as two separate phenomena, the first mitigated through imagery in the brain and the second through breathing in the brainstem during massage.

Figure 30: The brain behind myofascial trigger points

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