Myofascial Pain
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Definition[edit | edit source]
The myofascial pain syndrome is a common clinical problem of muscle pain involving sensory, motor and autonomic symptoms caused by myofascial trigger points.
A myofascial trigger point is defined as a hyperirritable spot, usually within a taut band of skeletal muscle wich is painful on compression and can give rise to characteristic referred pain, motor dysfunction and autonomic phenomena.
Classification and Clinical Presentation[edit | edit source]
Myofascial trigger points are classified into active and latent trigger points.
- An active trigger point is one with spontaneous pain or pain in response to movement that can trigger local or referred pain.
- A latent trigger point is a sensitive spot with pain or discomfort only elicited in response to compression.
The myofascial trigger points (active or latent) follow commom clinical characteristics such as:
- Pain on compression. Thit may elicit local pain and/or referred pain that is similar to a patient's usual clinical complaint or may aggravate the existing pain.
- Local twitch response. Snapping palpation (compression across the muscle fibers rapidly) may elicit a local twitch response, which is a quick contraction of the muscle fibers in or around the taut band.
- Muscle tightness. Restricted range of stretch, and increased sensitivity to stretch, of muscle fibers in a taut band may cause tightness of the involved muscle.
- Local myasthenia. The muscle with a trigger point may be weak, but usually no atrophy can be noticed.
- Patients with trigger points may have associated localized autonomic phenomena, including vasoconstriction, pilomotor response and hypersecretion.
Etiology[edit | edit source]
Several possible mechanisms can lead to the development of trigger points, including :
- Prolonged muscle contractures: Initially the taut band formation can reflect a muscle contracture. Prolonged contractures are likely to lead to the formation of latent trigger points, which can eventually evolve into active trigger points.
- Low-level muscle contractions
- Uneven intramuscular pressure distribution
- Direct trauma
- Eccentric contractions in unconditioned or unaccustomed muscle, and maximal or submaximal concentric contractions.
References[edit | edit source]
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