Myofascial Pain Syndrome Mattress Canada: Trigger Points

8 min read

Table of Contents

• Understanding Myofascial Pain Syndrome
• Trigger Points Explained
• How Myofascial Pain Affects Sleep
• Referred Pain Patterns at Night
• How Mattress Pressure Activates Trigger Points
• Mattress Firmness Guide for MPS
• Mattress Types Compared for Trigger Point Relief
• Sleeping Positions for Trigger Point Management
• Pillow Strategy for MPS
• Heat Therapy and Your Mattress
• Restonic ComfortCare for MPS Patients
• Frequently Asked Questions
• Sources

Understanding Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic pain condition that involves the muscles and the fascia, the thin connective tissue that wraps around every muscle in the body. Unlike generalized muscle soreness, MPS is characterized by the presence of trigger points: specific, hyper-irritable spots within a taut band of muscle that are painful when compressed and can produce referred pain in predictable patterns.

MPS is remarkably common. Studies suggest that myofascial trigger points are the primary source of pain in 30-85% of patients presenting to pain clinics. In Canada, where cold weather, sedentary work, and stress are common aggravating factors, MPS is a significant contributor to chronic pain and disability.

The condition can affect virtually any muscle in the body, but the most commonly involved muscles include the trapezius (upper back and shoulders), the levator scapulae (side of the neck), the quadratus lumborum (lower back), the piriformis (buttock), the infraspinatus (shoulder blade area), and the gluteus medius (hip). These are, not coincidentally, the areas most affected by mattress pressure during sleep.

How Trigger Points Form

Trigger points develop when muscle fibres contract and cannot fully release. This can result from acute trauma (such as a fall or car accident), repetitive microtrauma (such as poor posture at a desk), sustained muscle loading (such as carrying a heavy bag on one shoulder), emotional stress (which causes chronic muscle tension), sleep disturbances (which prevent the muscle repair that occurs during deep sleep), and cold exposure (which increases muscle tension).

Once a trigger point forms, it creates a self-perpetuating cycle. The contracted muscle fibres compress local blood vessels, reducing blood flow to the area. Reduced blood flow means less oxygen and nutrient delivery, and slower removal of metabolic waste products. This local ischemia (reduced blood flow) irritates the nerve endings in the muscle, causing pain. The pain causes further muscle guarding and tension, which further reduces blood flow, perpetuating the cycle.

Active vs. Latent Trigger Points

Trigger points can be either active or latent. Active trigger points cause spontaneous pain at rest and produce referred pain when compressed. Latent trigger points do not cause spontaneous pain but are tender when pressed and can restrict movement. Latent trigger points can become active due to various stressors, including poor sleep and sustained pressure from an inadequate mattress.

Trigger Points Explained

Understanding what trigger points are and how they behave is essential for choosing a mattress that does not aggravate them.

What a Trigger Point Feels Like

A trigger point feels like a small, hard nodule within the muscle. It is typically the size of a pea or a marble and is exquisitely tender to pressure. When you press on an active trigger point, you may feel local pain at the trigger point itself, referred pain in a specific, predictable pattern (for example, a trigger point in the upper trapezius muscle can refer pain up the side of the neck and into the temple), a twitch response (the muscle fibre jumps briefly when the trigger point is pressed), and a sensation of deep aching rather than sharp, superficial pain.

Common Trigger Point Locations and Their Sleep Implications

Each trigger point location has specific implications for sleep position and mattress selection.

Why Trigger Points Are Worse at Night

Several factors make trigger points more problematic at night. First, the body's natural pain-suppressing mechanisms are less active during sleep, which can make trigger point pain feel more intense. Second, the sustained pressure of body weight on the mattress can directly compress trigger points, activating pain responses. Third, the relative immobility of sleep allows trigger points to stiffen further, and fourth, reduced blood flow during sleep (particularly to pressure-loaded areas) prevents the clearing of metabolic waste products from trigger point regions.

How Myofascial Pain Affects Sleep

The relationship between myofascial pain syndrome and sleep is bidirectional and self-reinforcing. MPS disrupts sleep, and disrupted sleep worsens MPS.

Sleep Onset Difficulty

Finding a comfortable position to fall asleep can be the first challenge. Active trigger points in the shoulders, back, or hips may hurt when compressed by lying down. The patient may spend 30 minutes or more shifting positions, trying to find one that does not activate a trigger point. This extended time to fall asleep reduces total sleep duration and increases frustration and anxiety about sleep.

Frequent Waking

Even after falling asleep, trigger point activation can cause waking. When you roll onto a trigger point in your sleep, the pain signal can be strong enough to wake you. Some MPS patients report waking 5-10 times per night, each time needing to find a new position that avoids the painful trigger point.

Unrefreshing Sleep

Even when MPS patients manage to sleep through the night, their sleep quality is often poor. The constant low-level pain can prevent the brain from descending into the deep sleep stages that are most restorative. Polysomnographic studies of MPS patients show increased alpha wave intrusion during deep sleep, a pattern called alpha-delta sleep, which indicates the brain is partially awake even during what should be deep rest.

Morning Pain and Stiffness

Many MPS patients report that their worst pain occurs in the morning. This is partly due to the inflammatory process but also because the sustained pressure of sleeping in one or two positions for hours has compressed trigger points and reduced blood flow. A mattress that minimizes this overnight pressure can reduce morning pain severity.

Dorothy, Sleep Specialist at Mattress Miracle: "Myofascial pain syndrome is one of those conditions where the mattress can make a huge difference. I have seen customers who were waking up 6 or 7 times a night because of trigger point pain. After switching to a mattress with proper pressure relief, they were down to 1 or 2 awakenings. That is a life-changing improvement in sleep quality."

Referred Pain Patterns at Night

One of the most confusing aspects of myofascial pain syndrome is referred pain. A trigger point in one location can cause pain in a completely different area. Understanding common referred pain patterns helps MPS patients and their healthcare providers identify which trigger points are causing nighttime symptoms.

How Referred Pain Works

Referred pain occurs because of the way the nervous system processes pain signals. Pain signals from a trigger point travel along nerve pathways that also carry signals from other body areas. The brain can misinterpret the signal's origin, perceiving the pain as coming from a different location than the actual source.

This is relevant to mattress selection because patients may focus on cushioning the area where they feel pain, when the actual source (the trigger point) is elsewhere. For example, a patient with headaches upon waking might focus on their pillow, when the trigger point causing the headaches is actually in the upper trapezius muscle of the shoulder and requires better shoulder cushioning from the mattress.

Common Nighttime Referred Pain Patterns

Here are referred pain patterns that commonly affect sleep:

• Trigger points in the upper trapezius refer pain to the temple and behind the ear, causing morning headaches that patients may attribute to their pillow rather than their shoulder support.
• Trigger points in the infraspinatus (shoulder blade area) refer pain to the front of the shoulder and down the upper arm, causing patients to wake with what feels like shoulder joint pain.
• Trigger points in the quadratus lumborum (lower back) refer pain to the hip and buttock, causing pain that mimics hip joint problems.
• Trigger points in the piriformis (deep buttock) refer pain down the back of the thigh, mimicking sciatica. Patients may wake with leg pain that they attribute to a spinal problem.
• Trigger points in the soleus (calf muscle) refer pain to the lower back and sacroiliac area, a pattern that can be very confusing diagnostically.

How Mattress Pressure Activates Trigger Points

Understanding the mechanical relationship between mattress pressure and trigger point activation is fundamental to choosing the right mattress for MPS.

The Pressure-Pain Connection

Trigger points have a lower pressure-pain threshold than normal muscle tissue. This means they respond to lower levels of pressure with pain. A mattress surface that a healthy person finds comfortable may generate enough pressure to activate trigger points in an MPS patient.

The amount of pressure a mattress exerts on any given body area depends on several factors: the firmness of the mattress, the body weight of the sleeper, the sleeping position, the surface area of contact, and the duration of contact. A firmer mattress concentrates pressure over a smaller area (because it does not conform to the body's shape), while a softer mattress distributes pressure over a larger area (because it conforms more closely).

The Firmness Paradox

MPS patients face a firmness paradox. A softer mattress distributes pressure more evenly, which is good for avoiding trigger point activation. But a softer mattress can also allow the body to sink into misaligned positions, which creates muscle strain that perpetuates trigger points. Conversely, a firmer mattress maintains better alignment, but it concentrates pressure at trigger point locations.

The solution to this paradox is a mattress that provides targeted support: one that is softer where trigger points are located (to reduce pressure) and firmer where support is needed (to maintain alignment). This is exactly what individually pocketed coil systems achieve. Each coil responds independently to the weight above it, creating a surface that is automatically softer at protruding pressure points and firmer at areas that need support.

Duration of Pressure

The duration of pressure on a trigger point is just as important as the intensity. Even moderate pressure, sustained over several hours, can activate a latent trigger point and cause significant pain. This is why MPS patients who sleep through the night without position changes often wake in more pain than those who change positions several times.

A responsive mattress that facilitates easy position changes helps ensure that no single trigger point is compressed for too long. Pocketed coil mattresses are more responsive than memory foam, meaning they help the sleeper change positions with less effort.

Mattress Firmness Guide for MPS

Choosing the right firmness level is critical for MPS patients. Here is a detailed guide based on trigger point locations and sleep positions.

Firmness by Sleep Position

Your primary sleep position affects the optimal firmness level:

• Side sleepers with MPS: Need a medium to medium-soft mattress (4-6 on a 10-point scale) to allow the shoulder and hip to sink sufficiently, reducing pressure on trigger points in these areas. However, the mattress should not be so soft that the spine curves laterally.
• Back sleepers with MPS: Benefit from a medium-firm mattress (5-7 on a 10-point scale) that supports the natural curve of the lower back while providing enough cushioning for trigger points in the upper back and buttocks.
• Combination sleepers with MPS: Need a medium firmness (5-6 on a 10-point scale) that works reasonably well in multiple positions, combined with a responsive surface that facilitates frequent position changes.

Firmness by Body Weight

Body weight affects how deeply you sink into a mattress and therefore how much pressure is exerted on trigger points:

Testing Firmness in the Store

When testing mattresses in the store, lie in your primary sleeping position for at least 10 minutes. Pay attention to whether you feel the mattress pressing against any trigger point locations. Ask yourself: Does the mattress push back against my shoulder, or does the shoulder sink in gently? Can I feel the mattress pressing against my hip bone, or does the hip settle into the surface? When I change positions, does the mattress help me move, or does it resist movement?

Brad, Owner of Mattress Miracle, 40+ years of experience: "I always tell my MPS customers to take their time testing. Lie there for 10, 15, even 20 minutes in each position. A trigger point might not respond immediately. Give it time. If after 10 minutes you start to feel a familiar ache building, that mattress is not right for you. The right mattress should make your pain decrease as you lie on it, not increase."

Mattress Types Compared for Trigger Point Relief

Different mattress constructions offer different advantages and disadvantages for MPS patients.

Individually Pocketed Coil Mattresses (Hybrid)

Pocketed coil mattresses with foam comfort layers are our top recommendation for MPS patients. The pocketed coils provide targeted support (each coil responds independently), excellent airflow (which helps with heat therapy before bed), and responsive movement (making position changes easier). The foam comfort layers add cushioning that protects trigger points from direct coil pressure.

Memory Foam Mattresses

Memory foam provides excellent pressure distribution by conforming closely to the body's contours. This can be beneficial for trigger points because it spreads pressure over a large surface area, reducing peak pressure at any single point. However, memory foam's slow response makes position changes more difficult, it traps heat (which can be uncomfortable during summer), and it may not provide adequate support for heavier sleepers.

Latex Mattresses

Latex offers a combination of pressure relief and responsiveness that works well for many MPS patients. Natural latex conforms to the body while still pushing back, making position changes easy. It is also naturally breathable and durable. The main disadvantage is cost. Quality latex mattresses typically start at $2,000 for a Queen size.

Traditional Innerspring Mattresses

Traditional innerspring mattresses with interconnected coil systems are generally not recommended for MPS patients. The interconnected coils move together, which means pressure applied to one area affects the entire surface. This creates less targeted support and more motion transfer. Additionally, the thin padding layers on most innerspring mattresses provide insufficient cushioning for sensitive trigger points.

Adjustable Air Mattresses

Adjustable air mattresses allow you to change firmness, which can be useful for MPS patients whose needs change day to day. On a day when trigger points are more active, you can soften the surface; on a day when you need more support, you can firm it up. The disadvantage is that air chambers do not provide the same body-contouring pressure relief as foam or pocketed coils.

Sleeping Positions for Trigger Point Management

The optimal sleeping position for MPS depends on where your trigger points are located. Here are specific recommendations for common trigger point patterns.

Upper Trapezius and Neck Trigger Points

If your primary trigger points are in the upper trapezius and neck, back sleeping is usually the best option. It eliminates the compression that occurs when lying on the affected shoulder. Use a contoured cervical pillow that supports the neck's natural curve without pushing the head too far forward or backward. The pillow should fill the space between the neck and the mattress without lifting the head excessively.

Shoulder Blade (Infraspinatus/Rhomboid) Trigger Points

Trigger points in the shoulder blade area are compressed by both side sleeping and back sleeping. For back sleepers, a mattress with good contouring at the upper back area can help. For side sleepers, the mattress must allow the shoulder to sink in sufficiently to avoid pressing against the trigger points between the shoulder blade and the spine.

Lower Back (Quadratus Lumborum) Trigger Points

Back sleeping with a pillow under the knees reduces strain on the quadratus lumborum. Side sleeping with a pillow between the knees maintains hip alignment and reduces the lateral bending that can activate these trigger points. The mattress should provide firm support in the lumbar region to prevent excessive sinking.

Hip and Buttock (Piriformis/Gluteal) Trigger Points

These trigger points are most aggravated by side sleeping, where the full weight of the upper body compresses the hip and buttock. If side sleeping is your preferred position, you need a mattress that allows the hip to sink in enough to relieve direct pressure on these muscles. The Restonic ComfortCare's individually pocketed coils accommodate this by compressing under the hip's weight while maintaining support for the waist.

Pillow Strategy for MPS

For MPS patients, pillows are not just for the head. A strategic pillow setup can prevent trigger point activation throughout the body.

Head and Neck Pillow

The head pillow should maintain the cervical spine in a neutral position, meaning the neck is neither flexed forward, extended backward, nor tilted to one side. For back sleepers, this typically means a relatively thin, contoured pillow. For side sleepers, a thicker pillow is needed to fill the space between the shoulder and the ear.

An incorrect pillow is one of the most common perpetuating factors for trigger points in the neck and upper trapezius. If you wake with headaches or neck pain, your pillow is a prime suspect.

Knee and Leg Pillows

A pillow between the knees (for side sleepers) or under the knees (for back sleepers) reduces strain on the lower back, hip, and buttock muscles. This is particularly important for trigger points in the quadratus lumborum, piriformis, and gluteal muscles.

Arm Support Pillows

For side sleepers, a pillow or body pillow to support the upper arm prevents the arm's weight from pulling on the shoulder and upper back muscles. This is important for trigger points in the infraspinatus, rhomboid, and upper trapezius muscles.

The Body Pillow Advantage

A full-length body pillow can replace multiple individual pillows, providing support from the head to the knees in a single piece. For MPS patients who need to change positions during the night, a body pillow is often easier to manage than rearranging three or four separate pillows each time.

Heat Therapy and Your Mattress

Heat therapy is one of the most effective non-pharmacological treatments for myofascial trigger points. Understanding how your mattress interacts with heat therapy can help you maximize its benefits.

Why Heat Helps Trigger Points

Heat increases blood flow to the affected muscle. Since trigger points are partly sustained by local ischemia (reduced blood flow), increasing blood flow helps deliver oxygen and nutrients while removing metabolic waste products. Heat also relaxes muscle fibres, reducing the tension that holds the trigger point in its contracted state. Additionally, heat reduces pain perception by activating temperature-sensitive nerve fibres that compete with pain signals.

Pre-Sleep Heat Application

Applying heat to trigger point areas 15-30 minutes before bed can help relax the muscles before you lie down. Methods include a warm bath or shower (20-30 minutes, water temperature 37-40 degrees Celsius), a heating pad applied to specific trigger point areas (15-20 minutes), a microwaveable heat pack placed on trigger points (10-15 minutes), and a warm compress made with a towel soaked in hot water.

Mattress Heat Properties

A mattress that retains gentle body warmth can extend the benefits of pre-sleep heat therapy by keeping the muscles warm throughout the night. However, excessive heat retention can cause discomfort, particularly for people who tend to sleep warm.

The ideal mattress for MPS provides moderate heat retention: enough to maintain muscle warmth without causing overheating. The Restonic ComfortCare's combination of foam comfort layers (which retain some body heat) and pocketed coil airflow (which prevents excessive heat buildup) creates this balance.

Restonic ComfortCare for MPS Patients

The Restonic ComfortCare addresses the key mattress requirements for myofascial pain syndrome management. Here is a detailed analysis of why it works for trigger point sufferers.

Targeted Pressure Relief

The ComfortCare's individually pocketed coils provide targeted pressure relief that is essential for trigger point management. Each of the 1,222 coils (Queen) or 1,440 coils (King) responds independently to the weight above it. Where trigger points are located (typically at protruding body areas like the shoulder and hip), the coils compress more, reducing the pressure on these sensitive areas. Where the body needs support (like the waist and lumbar region), the coils provide firmer resistance.

Responsiveness for Position Changes

Unlike memory foam, which conforms slowly and resists movement, pocketed coils respond instantly. When an MPS patient needs to roll from one side to another (to relieve pressure on a trigger point), the ComfortCare facilitates this movement rather than resisting it. This responsiveness is critical because position changes are one of the most important strategies for preventing trigger point activation during sleep.

Balanced Temperature

The ComfortCare provides moderate heat retention, which is ideal for MPS patients. The foam comfort layers retain enough body warmth to keep muscles relaxed, while the pocketed coil system allows enough airflow to prevent overheating. This balance supports the muscle relaxation that helps manage trigger points without causing sleep-disrupting heat buildup.

Edge Support for Getting Up

MPS patients often experience pain when getting out of bed, particularly if they have trigger points in the lower back or hip. The ComfortCare's reinforced edge support provides a stable surface to push against when transitioning from lying to sitting to standing.

Value for Long-Term Management

At $1,619 for the Queen and $2,051 for the King, the ComfortCare is an affordable investment in trigger point management. MPS is often a chronic condition that requires ongoing management, and a quality mattress is a foundational element of that management plan. The ComfortCare's durability means it will continue providing effective pressure relief for years.

Complementary Strategies for MPS Sleep

While the mattress is a foundation, several complementary strategies can further improve sleep for MPS patients.

Self-Myofascial Release Before Bed

Using a foam roller, tennis ball, or massage ball to perform self-myofascial release before bed can deactivate trigger points and reduce pain at bedtime. Focus on the trigger points that are most active and that correspond to your sleep position. Spend 30-60 seconds on each trigger point, applying steady, moderate pressure.

Gentle Stretching

Light stretching of the muscles that contain your trigger points can reduce tension before bed. Hold each stretch for 30 seconds, breathing deeply. Avoid aggressive stretching, which can activate trigger points and increase pain.

Stress Reduction

Emotional stress is a major perpetuating factor for myofascial trigger points. Stress causes chronic muscle tension, which can activate latent trigger points and worsen active ones. Incorporating stress-reduction techniques such as deep breathing, meditation, or progressive muscle relaxation into your evening routine can help reduce trigger point activity before sleep.

Hydration

Dehydrated muscles are more prone to trigger point formation and activation. Ensure adequate water intake throughout the day (approximately 2 litres for most adults). However, reduce fluid intake in the last 1-2 hours before bed to minimize nighttime bathroom trips that disrupt sleep.

Talia, Showroom Specialist at Mattress Miracle: "I love working with MPS customers because the mattress really can make a measurable difference. I had a customer last month who had been dealing with trigger points in her hips for years. She was sleeping on an old innerspring mattress that was just pushing right into those sore spots. We set her up with a Restonic ComfortCare, and she called two weeks later to tell me she was sleeping through the night for the first time in years. That is why I come to work every day."

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