Pain and dysfunction of the musculoskeletal system can have different causes. Musculature as the primary cause of pain and functional impairment have long been neglected. The muscles have a great influence on disorders of the musculoskeletal organ and can directly cause both acute and chronic pain conditions. Travell and Simons show that the "myofascial trigger points" they describe, are very often responsible as a dominant disease factor for pain and functional limitations in the neuro-musculo-skeletal system. Those myofascial trigger points are zones in a muscle which are created by overloading or traumatic overstretching and are characterized by hypoxia (lack of oxygen).

Myofascial trigger points are palpable, provocation by means of pressures triggers pain that is often transmitted to other parts of the body (referred pain).