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Irritable Bowel


Pain that feels like it's coming from your esophagus, stomach, duodenum, intestines, gallbladder, or kidneys may actually be coming from myofascial trigger points (tiny contraction knots) in stressed or overworked abdominal muscles. Back pain, rectal pain, and genital pain are also known to be produced by abdominal trigger points.

These intriguing facts derive from decades of pain research by Doctors Janet Travell and David Simons, extensively described in their widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual.


Referred Pain

Travell and Simons found that trigger points in the abdominal area can be "diagnosically very misleading." This is because trigger points typically cause referred pain. That is, they send their pain to some other site.

For example, stomachaches, stomach cramps, heartburn, or burning pain that feels like an ulcer can be nothing more than referred pain from trigger points in the abdominal muscles. It's important to know that referred myofascial pain can be as intense and intolerable as pain from any other cause.

The pain can be so intense, in fact, that the doctor may want to do tests for stomach cancer, hiatal hernia, and gallstones. Pain from a trigger point in the rectus abdominis muscle can also imitate acute appendicitis.

Mystifying Symptoms

Gallbladder removal is done more often than any other type of surgery in the U.S. (over 600,000 per year). It's not uncommon for abdominal pain to remain after your gallbladder is gone. This can be worrisome for both doctor and patient.

But the pain may not be a residual problem with the biliary system. It may be nothing more serious than referral from trigger points in the abdominal muscles, which can do a very convincing job of mimicking gallbladder and bile duct symptoms.

Irritable bowel syndrome (IBS) is a very popular diagnosis, but it's only a label given to abdominal symptoms when the true cause is unknown. When the tests all come up negative, there's an extremely high probability that trigger points are the source of the problem.

Any physician should know that trigger points are always exquisitely tender, and that pressure on abdominal trigger points very often reproduces or accentuates their referred pain.

Surprising Connections

Doctors Travell and Simons discovered that other symptoms from abdominal trigger points can take the form of nausea, chronic diarrhea, loss of appetite, projectile vomiting, and simple indigestion.

The pain of colic in a baby can be from trigger points in his or her stomach muscles. Abdominal trigger points can also produce pain and other false symptoms in the bladder, colon, rectum, and the genitals of either sex.

Back Pain

back pain

The current fad for hardening the stomach muscles with vigorous exercise may have lured you into overworking this vulnerable area.

Seeking a well-defined "six-pack" or "abs of steel" can leave you with vicious abdominal trigger points. This can be the simple explanation for your mysterious back pain or any of the other symptoms listed above.

Abdominal exercises are not a solution for back pain if their effect is to make it worse!

It goes without saying that your abdominal symptoms can be signs of a serious medical condition. But physicians who are uninformed about trigger points and myofascial pain can be led to a wide range of mistaken diagnoses and misdirected treatment, including needless "exploratory" surgery.


Trigger points should be at the top of the list during any examination for pain and other abnormal symptoms in the abdomen. When healthcare practitioners have had adequate training and experience, trigger points are easy to locate and treat. In fact, there are ways to treat them yourself quite effectively.

trigger points workbook

In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies simplifies Travell and Simons's extensive research into myofascial pain and makes it accessible to the layman.

His innovative methods of self-applied trigger point massage will get rid of abdominal pain, heartburn, irritable bowel syndrome, rectal pain, back pain, chronic diarrhea, and genital pain, when trigger points are the cause.

To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.

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