Trigger point release may be done with the practitioner’s hands, as a type of massage treatment, or by using small needles, known as dry needling. It can help relieve pain and other symptoms.

Trigger point release can help manage symptoms like painful intercourse, overactive bladder, and constipation. There are minimal risks involved in conservative measures, but injections can cause infection and bleeding. However, these complications are very rare.

Read on to learn more about pelvic floor trigger point release, including uses, how it works, alternative treatments, risks, benefits, and when to see a doctor.

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The pelvic floor comprises a web of muscles that support the bladder, bowel, and uterus. It helps control bowel and bladder function and can influence sexual intercourse.

In some people, pelvic floor muscles become tense and develop tender, painful contraction knots called trigger points. Causes may include a sudden trauma or repeated microtrauma.

“Pelvic floor trigger release is an intervention done to treat pelvic floor dysfunction that stems from tight muscle tone,” says urologist Raveen Syan, MD. “Typically, pelvic floor physical therapy specialists provide the treatment.”

Pelvic trigger points affect up to 85% of people who experience colorectal, urological, and gynecological pelvic pain syndromes. Releasing painful knots can help with symptom management.

Syan notes that since pelvic floor trigger point release reduces muscle tone, it may help relieve:

  • painful sexual intercourse
  • chronic (long-term) pelvic pain
  • bladder issues, such as bladder pain syndrome and overactive bladder
  • defecatory dysfunction that involves symptoms such as constipation and pain during bowel movements

“Physical therapists identify the area of muscles or muscle that is likely the source of discomfort,” explains Syan. “They then perform trigger release with manual massage and may include biofeedback therapies or other electrical stimulation therapies to relax the muscles.”

Biofeedback measures the contractions of the pelvic floor muscles and relays the information to the individual. This allows them to practice relaxing the tense muscle while receiving real-time data.

If trigger point release is ineffective, a doctor may recommend alternative treatment methods for pain management.

“Alternative therapies include deep breathing techniques and muscle relaxation techniques without direct massage,” said Syan. “More invasive or aggressive interventions involve injections.”

Diaphragmatic breathing

Diaphragmatic breathing promotes relaxation, which may help reduce pain and foster optimal muscle function. The steps are as follows:

  1. Place one hand over the chest and the other hand over the abdomen right below the rib cage.
  2. Inhale, or take a deep breath, to the count of 3 seconds, and then exhale, or let out the breath, to the count of four seconds. People are doing this correctly if the belly rises with the inhale and falls with the exhale.
  3. Do this for 5–10 minutes daily.

Dry needling and trigger point injections

Dry needling involves inserting a thin needle into the trigger point. The practitioner may move the needle around to try and elicit a “local twitch response,” which is a spasm of the muscle. Once the muscle twitch stops or the trigger point relaxes, the practitioner will remove the needle.

Trigger point injections entail injecting a local anesthetic, such as lidocaine, into the muscle. According to a 2022 study, dry needling and lidocaine injections produce similar results.

Research states that sometimes doctors may use a Botox injection instead of lidocaine.

Massage and diaphragmatic breathing have very few risks and are considered conservative treatment methods.

However, trigger point injections are associated with some risks. These include:

  • pain
  • infection
  • bleeding
  • allergic reaction to the anesthetic
  • formation of a hematoma, or a severe bruise
  • systemic toxic effects of the anesthetic
  • injury to blood vessels

Side effects of dry needling include:

  • soreness
  • bleeding
  • fainting

Research supports the value of pelvic trigger release. Evidence suggests that conservative methods can result in a significant improvement in symptoms.

A 2019 study found that modifying the tone of pelvic muscles is an effective way to treat painful sexual intercourse.

Syan urges people to contact a doctor who specializes in pelvic floor disorders whenever they have any of these symptoms:

  • pain with sexual intercourse
  • chronic pelvic pain
  • bladder issues

Pelvic floor trigger point release involves interventions to reduce muscle tone in the pelvis. Because tight muscles can cause pain and affect urination, defecation, and sexual intercourse, the therapy may help relieve associated symptoms.

The treatments may consist of conservative physical therapy measures, such as manual massage.

A person with chronic pelvic pain or the symptoms it can cause should see a doctor.