Pressure causes hypoxia and reactive hyperemia that clears the trigger point. Effective, but painful. Myofascial release uses ischemic compression combined with passive stretching of the muscles during the compression. Also effective, but painful. Puncture, either by dry needling, or by injection of saline, or with local anesthetic.
Local anesthetics require the least precise placement but cause muscle necrosis.
A sustained application of ultrasound at low intensity inactivates trigger points. Microcurrent applied polarized on the trigger point with either probes or graphite gloves has been shown to be effective. Supplement B vitamins, especially B1, B6, B12, folate, Vitamin C and minerals. Some people use it as a treatment for myofascial pain although we haven't found it to be useful when used by itself without local treatment. Reconditioning is essential.