Trigger points can be treated using rounded wooden things that physios I know seem to find/ get someone to make. It's not the same feeling as your own thumbs and I wouldn't use them for the initial finding of the taught band but it does save thumbs. Couldn't help letting out a weird smile reading your mail, Eire, as I was sitting with a taped right thumb at the time (base of thumb problems) The left one hurts less. Physios have thumbs that take a hammering over years. When we aren't working them to death we ride bikes and do other sports to strain them etc etc. If you start to get severe problems, or rather beforehand, consider other options in terms of full time physio work where you'd be happy. Do CPD enough to change direction to less "thumbs on". Then there are wrists and backs to consider of course.....As we are human beings we are likely to get degenerative changes, Heberdens nodes (mine are wonderful)and all sorts of things sooner or later, like the general population does. It's a schizo profession, we often get our aches and pains while taking away other peoples aches and pains