Trigger Points
Original Editors -Sean Wauters
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Search Strategy[edit | edit source]
Keywords : Trigger points AND therapy AND/OR injection AND/OR exercise
Consulted databases : Pubmed, Pedro, Web of Knowledge
Definition/Description[edit | edit source]
A Trigger Point (TrPt) is a hyperirritable spot associated within a taut band of a skeletal muscle that is painful on compression or muscle contraction , and usually responds with a referred pain pattern distant from the spot. Very often there are nodules palpable within the muscle often at the size of 2-10 mm. [1] [2] [3] [4]
Clinically Relevant Anatomy[edit | edit source]
Trigger points may be at different places in both skeletal muscles in the hip, neck, shoulder, ... they are usually in places where nerves connected the muscle fibers. [5]
Epidemiology /Etiology[edit | edit source]
These are mainly due to overload, an injury sustained by a fall, by stress or birth trauma. Also a lack of exercise or a bad posture can lead to trigger points. [6] Trigger points have proven bone or myofascial pain Causes That are Responsible for neck and back pain.
Characteristics/Clinical Presentation[edit | edit source]
Trigger points are painful on compression or elongation of tissues and can also cause referred pain in a specific dermatomal and myotomal pattern. This could be possible by clamping the nerves or blood vessels bulge. The higher and continuing tension in the muscle can also be experienced stiffness and movement restrictions. [2]
Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
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Examination[edit | edit source]
The study of trigger points can be recorded by palpation. The examintor will clearly able to sense a hardening and concern with the patient reported tenderness or pain during palpation.
Medical Management
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Physical Therapy Management
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There are several methods for the treatment of trigger points.
First the exact location of the trigger point should be palpated.
Trigger points may be relieved through noninvasive measures, such as spray and stretch, transcutaneous electrical stimulation, physical therapy, and massage. [7]
Several studies have shown that ultrasound can help to treat trigger points, this treatment is very often followed by massage using transverse friction. [8] Massage can cause the soft tissue back and that the different sarcomeres in the muscle of each other loose.
Apart from these various methods can also be used invasive methods such as injections.
It is very important to inject the right place. For this, a study demonstrated that placing an injection using an ultrasound can help. Echo Conductive trigger point injections may help for proper placement of the needle into the muscle. [7]
Key Research[edit | edit source]
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Resources
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ Fernández-de-las-Peñas,C.etal. Myofascial trigger points and sensitization: an updated pain model for tension-type headache,Cephalalgia, 2007, 27, 383–393
- ↑ 2.0 2.1 David, J., et al. ‘Trigger Points: Diagnosis and Management’, Practical Therapeutics., 2002, 65(4) pg. 653 – 660
- ↑ Davidoff, RA. Trigger points and myofascial pain: toward understanding how they affect headachesCEPHALALGIA 1998,18, 436-448
- ↑ Eduardo Vázquez Delgad, et al. Myofascial pain syndrome associated with trigger points: A literature review. (I): Epidemiology, clinical treatment and etiopathogeny Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14 (10):494-498.
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedSimson 1999 - ↑ Han SC, Harrison P. Myofascial pain syndrome and trigger-point management. Reg Anesth 1997;22: 89-101.
- ↑ 7.0 7.1 Kenneth, P., et al. ‘Ultrasound-Guided Trigger Point Injections in the Cervicothoracic Musculature’, Pain Physician, 2008, 11, pg. 885-889
- ↑ Arne, N., et al. ‘Treatment of myofascial trigger-points with ultrasound combined with massage and exercise – a randomised controlled trial’., 1998, 77 pg. 73-79
