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Travell, MD felt it important to address/treat the Secondary MTrPs also for full relief of pain in a particular area. Secondary MTrP Symptoms - These Muscle Trigger Points (MTrPs) are the ones that continue the pain in a particular area AFTER you have treated all the Primary MTrPs. Primary MTrP Symptoms - These Muscle Trigger Points (MTrPs) are the Primary (Main) and the most often cause of pain in a particular area, the Pain Referral area of the MTrPs. This example diagram is for the Abductor Digiti Minimi for the foot:

The red shaded area is the referred pain caused by the Trigger Point and the darker red means more people experienced pain in that area.

The X's represent the Trigger Points. There is no difference between the black and white X’s.