These two closely related therapies address muscular pain through the application of deep pressure to the painful areas, some of which may be trigger-points.

"Myotherapy," also called "trigger-point myotherapy," literally means "muscle therapy," and has become a synonym for massage. However, the term originated with Bonnie Prudden, (Pain Erasure, 1980) who uses it to describe a particular type of trigger-point therapy, and this is how we, too, use the term.

Neuro-muscular massage therapy (NMT) was developed by Paul St. John, Judith Walker DeLany, and others. The myotherapist generally uses static pressure to treat the muscle, while the neuro-muscular massage therapist uses a deep "stripping" massage along the length of the muscle and its tendons, stopping at particularly tender or congested areas to press more deeply.

What is a trigger-point? A trigger-point is a very irritable spot within a taut band of muscle, which triggers pain and/or weakness and restriction, usually in locations distant from the trigger-point. For instance, headaches may come from trigger-points in neck muscles; arm pain may come from trigger-points in neck or shoulder muscles. Each muscle has its own characteristic pain pattern, and these patterns have been well mapped and described in the works of Janet Travell, M.D., and David Simons, M.D. (Myofascial Pain and Dysfunction, The Trigger-Point Manual, Vol. 1, 1983; Vol. 2, 1992) The therapist knows these patterns and uses them to locate and treat the sources of pain and dysfunction.

Why does the therapist press on trigger-points and other painful areas in the muscles? Such regions are typically ischemic, i.e. lacking in oxygen, because their circulation has become impaired. Both static pressure and deep stroking massage help restore circulation. Because the muscles involved are typically shortened, corrective exercise (particularly stretching and range of motion exercise) is important to the client's rehabilitation, and may be suggested by the therapist.

Therapists with training in Trigger-Point Myotherapy and/or NMT: Dina ClevensonLeane Abbott, Sheri Bergen and Marc Parsont