Myofascial Pain Syndrome and Trigger Points Quiz

Myofascial Pain Syndrome and Trigger Points

• Myofascial Pain Syndrome (MPS) is a set of signs and symptoms caused by myofascial trigger points (MTrPs).

• MTrPs are hyperirritable areas in skeletal muscle associated with a palpable nodule located in a taut band formed by muscle fibers.

• MTrPs are painful on stimulation and may give rise to characteristic referred pain, referred pressure hypersensitivity, motor dysfunction, and autonomic phenomena.

• MTrPs must be distinguished from cutaneous, ligamentous, periosteal, or any other nonmuscular TP.

• The concept of MTrPs dates back to the 16th century, and the term was coined in the 20th century by Travell and Rinzler.

• MTrPs can be classified as active or latent, central or insertional, and key or satellite.

• Clinically relevant MTrPs are those that, regardless of being active or latent, should be treated because of their importance in the patient's clinical picture.

• Latent MTrPs can cause limitation of ROM and pain, muscle fatigue, weakness, and muscle cramp.

• MTrPs can be activated directly or indirectly, and they can provoke symptoms in prescribed areas and induce motor activity in other muscles.

• The essential diagnostic criteria for MTrPs include a palpable taut band, exquisite spot tenderness of a nodule in a taut band, patient's recognition of current pain complaint by pressure on the tender nodule, and painful limit to full stretch range of motion.

• Perpetuating factors can prevent the healing of MPS despite proper treatment, and they can include mechanical stress, nutritional inadequacies, metabolic and endocrine inadequacies, and psychological factors.

• It is necessary to identify and address perpetuating factors to achieve a successful treatment outcome for MPS.Myofascial Pain Syndrome: Pathogenesis, Physiopathology, and Treatment Techniques

• Myofascial Pain Syndrome (MPS) is a chronic pain condition characterized by the presence of trigger points, or MTrPs.

• MTrPs are hyperirritable spots within taut bands of skeletal muscles that cause pain and dysfunction.

• MPS can be caused by various factors, including poor posture, repetitive motions, trauma, and toxic habits like smoking and alcoholism.

• The pathogenesis of MTrPs is still not fully understood, and there are multiple hypotheses, including the Energy Crisis Hypothesis, Muscle Spindle Hypothesis, Neuromuscular Junction Hypothesis, and Integrated Hypothesis.

• The Integrated Hypothesis is the most widely accepted and suggests that MTrPs are caused by a combination of energy crisis and neuromuscular dysfunction.

• MTrPs can be treated conservatively or invasively, and techniques include stretching, massage therapy, thermotherapy, electrotherapy, and compression techniques.

• Ischemic compression is a common technique used to treat MTrPs, where pressure is applied to the trigger point until the patient feels pain and then maintained for a certain amount of time before releasing.

• Intermittent compression is another technique where pressure is applied and released in a specific pattern to reduce pain and tension in the muscle.

• Trigger point pressure release is similar to ischemic compression, but the focus is on releasing muscle tension rather than eliciting referred pain.

• Treatment of MPS typically involves pain control in the first phase, followed by addressing perpetuating factors like mechanical and postural issues, systemic and metabolic issues, and muscle conditioning.

• There are rules for the treatment of MPS, including treating proximal MTrPs before distal ones and treating medial MTrPs before lateral ones.

• In addition to treatment techniques, objective measures like EMG, elastography, ECO Dopler, and ultrasound can be used to confirm the presence and severity of MTrPs.Treatment Techniques for Myofascial Pain Syndrome

• Trigger point pressure release involves increasing pressure until pain is felt, then repeating until muscle tension is no longer felt.

• Compression MTrP + contraction involves locating the trigger point and compressing it while asking for a concentric or isometric contraction of the muscle to be treated.

• Muscle energy techniques take advantage of muscle contraction, such as post-isometric relaxation and stretching post-contraction.

• The Swiss approach to treatment involves sustained compression, ischemic compression, local stretching, fascial massage, and analytical stretching.

• Invasive treatment options include chemical substance infiltration, dry techniques, and dry needling.

• Chemical substances used for infiltration include analgesics, corticosteroids, local anesthetics, and botulinum toxin.

• Botulinum toxin A (BTA) provides chemical and localized denervation, resulting in relaxation of involuntary muscle contracture and reduction of pain.

• Dry needling involves inserting needles through the skin without injecting or extracting any substance and can be either superficial or deep.

• Superficial dry needling involves inserting the needle into cutaneous and subcutaneous tissue to activate central analgesic mechanisms.

• Deep dry needling involves inserting the needle through the trigger point and producing local twitch responses for greater clinical effectiveness.

• Percutaneous electrostimulation of the MTrPs involves using tweezers clasped to the needles and applying a high-intensity, short-duration current.

• Intratissue percutaneous electrolisis (EPI) involves applying a continuous current through a needle to produce a controlled inflammatory response for tissue repair and regeneration.

Myofascial Pain Syndrome and Trigger Points

• Myofascial Pain Syndrome (MPS) is a set of signs and symptoms caused by myofascial trigger points (MTrPs).

• MTrPs are hyperirritable areas in skeletal muscle associated with a palpable nodule located in a taut band formed by muscle fibers.

• MTrPs are painful on stimulation and may give rise to characteristic referred pain, referred pressure hypersensitivity, motor dysfunction, and autonomic phenomena.

• MTrPs must be distinguished from cutaneous, ligamentous, periosteal, or any other nonmuscular TP.

• The concept of MTrPs dates back to the 16th century, and the term was coined in the 20th century by Travell and Rinzler.

• MTrPs can be classified as active or latent, central or insertional, and key or satellite.

• Clinically relevant MTrPs are those that, regardless of being active or latent, should be treated because of their importance in the patient's clinical picture.

• Latent MTrPs can cause limitation of ROM and pain, muscle fatigue, weakness, and muscle cramp.

• MTrPs can be activated directly or indirectly, and they can provoke symptoms in prescribed areas and induce motor activity in other muscles.

• The essential diagnostic criteria for MTrPs include a palpable taut band, exquisite spot tenderness of a nodule in a taut band, patient's recognition of current pain complaint by pressure on the tender nodule, and painful limit to full stretch range of motion.

• Perpetuating factors can prevent the healing of MPS despite proper treatment, and they can include mechanical stress, nutritional inadequacies, metabolic and endocrine inadequacies, and psychological factors.

• It is necessary to identify and address perpetuating factors to achieve a successful treatment outcome for MPS.Myofascial Pain Syndrome: Pathogenesis, Physiopathology, and Treatment Techniques

• Myofascial Pain Syndrome (MPS) is a chronic pain condition characterized by the presence of trigger points, or MTrPs.

• MTrPs are hyperirritable spots within taut bands of skeletal muscles that cause pain and dysfunction.

• MPS can be caused by various factors, including poor posture, repetitive motions, trauma, and toxic habits like smoking and alcoholism.

• The pathogenesis of MTrPs is still not fully understood, and there are multiple hypotheses, including the Energy Crisis Hypothesis, Muscle Spindle Hypothesis, Neuromuscular Junction Hypothesis, and Integrated Hypothesis.

• The Integrated Hypothesis is the most widely accepted and suggests that MTrPs are caused by a combination of energy crisis and neuromuscular dysfunction.

• MTrPs can be treated conservatively or invasively, and techniques include stretching, massage therapy, thermotherapy, electrotherapy, and compression techniques.

• Ischemic compression is a common technique used to treat MTrPs, where pressure is applied to the trigger point until the patient feels pain and then maintained for a certain amount of time before releasing.

• Intermittent compression is another technique where pressure is applied and released in a specific pattern to reduce pain and tension in the muscle.

• Trigger point pressure release is similar to ischemic compression, but the focus is on releasing muscle tension rather than eliciting referred pain.

• Treatment of MPS typically involves pain control in the first phase, followed by addressing perpetuating factors like mechanical and postural issues, systemic and metabolic issues, and muscle conditioning.

• There are rules for the treatment of MPS, including treating proximal MTrPs before distal ones and treating medial MTrPs before lateral ones.

• In addition to treatment techniques, objective measures like EMG, elastography, ECO Dopler, and ultrasound can be used to confirm the presence and severity of MTrPs.Treatment Techniques for Myofascial Pain Syndrome

• Trigger point pressure release involves increasing pressure until pain is felt, then repeating until muscle tension is no longer felt.

• Compression MTrP + contraction involves locating the trigger point and compressing it while asking for a concentric or isometric contraction of the muscle to be treated.

• Muscle energy techniques take advantage of muscle contraction, such as post-isometric relaxation and stretching post-contraction.

• The Swiss approach to treatment involves sustained compression, ischemic compression, local stretching, fascial massage, and analytical stretching.

• Invasive treatment options include chemical substance infiltration, dry techniques, and dry needling.

• Chemical substances used for infiltration include analgesics, corticosteroids, local anesthetics, and botulinum toxin.

• Botulinum toxin A (BTA) provides chemical and localized denervation, resulting in relaxation of involuntary muscle contracture and reduction of pain.

• Dry needling involves inserting needles through the skin without injecting or extracting any substance and can be either superficial or deep.

• Superficial dry needling involves inserting the needle into cutaneous and subcutaneous tissue to activate central analgesic mechanisms.

• Deep dry needling involves inserting the needle through the trigger point and producing local twitch responses for greater clinical effectiveness.

• Percutaneous electrostimulation of the MTrPs involves using tweezers clasped to the needles and applying a high-intensity, short-duration current.

• Intratissue percutaneous electrolisis (EPI) involves applying a continuous current through a needle to produce a controlled inflammatory response for tissue repair and regeneration.

Myofascial Pain Syndrome and Trigger Points

• Myofascial Pain Syndrome (MPS) is a set of signs and symptoms caused by myofascial trigger points (MTrPs).

• MTrPs are hyperirritable areas in skeletal muscle associated with a palpable nodule located in a taut band formed by muscle fibers.

• MTrPs are painful on stimulation and may give rise to characteristic referred pain, referred pressure hypersensitivity, motor dysfunction, and autonomic phenomena.

• MTrPs must be distinguished from cutaneous, ligamentous, periosteal, or any other nonmuscular TP.

• The concept of MTrPs dates back to the 16th century, and the term was coined in the 20th century by Travell and Rinzler.

• MTrPs can be classified as active or latent, central or insertional, and key or satellite.

• Clinically relevant MTrPs are those that, regardless of being active or latent, should be treated because of their importance in the patient's clinical picture.

• Latent MTrPs can cause limitation of ROM and pain, muscle fatigue, weakness, and muscle cramp.

• MTrPs can be activated directly or indirectly, and they can provoke symptoms in prescribed areas and induce motor activity in other muscles.

• The essential diagnostic criteria for MTrPs include a palpable taut band, exquisite spot tenderness of a nodule in a taut band, patient's recognition of current pain complaint by pressure on the tender nodule, and painful limit to full stretch range of motion.

• Perpetuating factors can prevent the healing of MPS despite proper treatment, and they can include mechanical stress, nutritional inadequacies, metabolic and endocrine inadequacies, and psychological factors.

• It is necessary to identify and address perpetuating factors to achieve a successful treatment outcome for MPS.Myofascial Pain Syndrome: Pathogenesis, Physiopathology, and Treatment Techniques

• Myofascial Pain Syndrome (MPS) is a chronic pain condition characterized by the presence of trigger points, or MTrPs.

• MTrPs are hyperirritable spots within taut bands of skeletal muscles that cause pain and dysfunction.

• MPS can be caused by various factors, including poor posture, repetitive motions, trauma, and toxic habits like smoking and alcoholism.

• The pathogenesis of MTrPs is still not fully understood, and there are multiple hypotheses, including the Energy Crisis Hypothesis, Muscle Spindle Hypothesis, Neuromuscular Junction Hypothesis, and Integrated Hypothesis.

• The Integrated Hypothesis is the most widely accepted and suggests that MTrPs are caused by a combination of energy crisis and neuromuscular dysfunction.

• MTrPs can be treated conservatively or invasively, and techniques include stretching, massage therapy, thermotherapy, electrotherapy, and compression techniques.

• Ischemic compression is a common technique used to treat MTrPs, where pressure is applied to the trigger point until the patient feels pain and then maintained for a certain amount of time before releasing.

• Intermittent compression is another technique where pressure is applied and released in a specific pattern to reduce pain and tension in the muscle.

• Trigger point pressure release is similar to ischemic compression, but the focus is on releasing muscle tension rather than eliciting referred pain.

• Treatment of MPS typically involves pain control in the first phase, followed by addressing perpetuating factors like mechanical and postural issues, systemic and metabolic issues, and muscle conditioning.

• There are rules for the treatment of MPS, including treating proximal MTrPs before distal ones and treating medial MTrPs before lateral ones.

• In addition to treatment techniques, objective measures like EMG, elastography, ECO Dopler, and ultrasound can be used to confirm the presence and severity of MTrPs.Treatment Techniques for Myofascial Pain Syndrome

• Trigger point pressure release involves increasing pressure until pain is felt, then repeating until muscle tension is no longer felt.

• Compression MTrP + contraction involves locating the trigger point and compressing it while asking for a concentric or isometric contraction of the muscle to be treated.

• Muscle energy techniques take advantage of muscle contraction, such as post-isometric relaxation and stretching post-contraction.

• The Swiss approach to treatment involves sustained compression, ischemic compression, local stretching, fascial massage, and analytical stretching.

• Invasive treatment options include chemical substance infiltration, dry techniques, and dry needling.

• Chemical substances used for infiltration include analgesics, corticosteroids, local anesthetics, and botulinum toxin.

• Botulinum toxin A (BTA) provides chemical and localized denervation, resulting in relaxation of involuntary muscle contracture and reduction of pain.

• Dry needling involves inserting needles through the skin without injecting or extracting any substance and can be either superficial or deep.

• Superficial dry needling involves inserting the needle into cutaneous and subcutaneous tissue to activate central analgesic mechanisms.

• Deep dry needling involves inserting the needle through the trigger point and producing local twitch responses for greater clinical effectiveness.

• Percutaneous electrostimulation of the MTrPs involves using tweezers clasped to the needles and applying a high-intensity, short-duration current.

• Intratissue percutaneous electrolisis (EPI) involves applying a continuous current through a needle to produce a controlled inflammatory response for tissue repair and regeneration.