If you leave a muscular trigger point untreated, can it become permanent?

Not Necessarily: It can become chronic, but not necessarily permanent. The longer a muscle injury remains untreated, the harder it can be to treat it. If it has become chronic, once the trigger point is broken up/treated, you will need additional therapy to "retrain' the muscles involved to stay as a normal muscle and not slice back into the old injury.

Trigger Points: I agree with dr. Eitner. Trigger points can become hard wired in. There are a number of acupuncture techniques which consistently yield very good results with trigger (ashi) points. Many of my patients are also being treated by physical therapists ;/or an excellent chiropractic.