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The
Metabolic Treatment A
Guide to
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Myofascial Pain Syndrome
 Dr. John C. Lowe In Myofascial Pain and Dysfunction: The Trigger Point Manual, vol.1, the authors explain that the term "myofascial pain syndrome" has been used in two different ways. Some practitioners use it to refer to any regional pain syndrome of soft tissue origin. Other practitioners, such as Travell and Simons, use the term to refer to sensory, motor, and autonomic symptoms caused by myofascial trigger points.[1,p.5] The most common sensory symptom is pain. A motor symptom is muscle weakness, and an autonomic symptom is tearing. The term "myofascial pain syndrome" is best reserves for this second definition. The authors of the Trigger Point Manual define "myofascial trigger point" this way: "A hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band." They also write, "The spot is painful on compression and can give rise to characteristic referred pain, referred tenderness, motor dysfunction, and autonomic phenomena."[1,p.5]
The term "latent" means that the trigger points (1) increase tension in the muscle and restrict range of motion, but (2) they don't refer pain until compressed. They can become compressed a clinician palpates the muscle or when the tension of the muscle increases during activity such as carrying a purse or brief case with the right hand. We can experience referred myofascial pain by squeezing the muscle between the fingers of the left hand. Psychologist Ron Melzack (who co-authored the gating theory of pain) points out that trigger points may form at the site of even minor injuries. He writes that major procedures such as cordotomies may fail to relieve pain. ("Cordotomy" is division of nerve tracts of the spinal cord. The division may be made by techniques such as incision or radio frequency coagulation.) On the other hand, simple procedures such as trigger point treatment techniques may produce sudden, remarkable recovery and a return to work.[2,p.111] Trigger points are the easiest-to-confirm mechanism of pain, yet the most neglected.[3] We can document trigger points by thermography and algometry. For most clinical purposes, however, this isn't necessary. When properly trained, the practitioner can locate myofascial trigger points through manual palpation with a highly degree of reliability.[4,p.33-36] References 1. Simons, D.G., Travell, J.G.,
and Simons, L.S.: Myofascial Pain and Dysfunction: The Trigger Point
Manual, vol.1, Upper Half of the Body. Baltimore, Williams &
Wilkins, 1999. |
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