Myofascial Pain Syndrome
Is a syndrome cahracterized by chronic pain in multiple myofascial trigger points and fascial constrictions.
Characteristic features of a myofascial trigger point include focal point tenderness, reproduction of pain upon trigger point palpation, hardening of the muscle upon trigger point palpation, pseudo-weakness of the involved muscle, referred pain, and limited range of motion following 5 seconds of sustained trigger point pressure.
Spot tenderness in taut band with firm pressure applied for ~5 seconds
Expected distribution of referred pain from a myofascial TrP
Taut band in accessible muscle
Regional pain complaint
Restricted ROM when measurable
Latent Trigger Points
Stiffness with restricted range of motion
Only tender on palpation; no spontaneous pain
Active Trigger Points
Spontaneous pain + referred pain characteristic of a patient's pain on palpation.
Dynamic Trigger Points
May change from being a non-tender taut band, to a latent trigger point, to an active trigger point.
These are all dynamic.
Integrated Trigger Point Hypothesis
Injury to muscle can cause an increased ACh transmission which can lead to contraction. Prolonged contraction can cause hypoxia, which can eventually cause peripheral nociceptor sensitization.
Causes of MPS
Is a symptom, not a cause.
Treatment of Trigger Points
Transfers load between the trunk and the lower extremities during both static and dynamic activities.
It is essentially a keystone.