Myofascial Pain Flashcards
True or false: MFP are not common, but when found are often diagnose quickly
False–extremely common, and usually go undiagnosed for years
What is the definition of myofascial pain?
Pain caused by an area of hypersensitivity in a muscle and its fascia
MFP are often confused with what?
Visceral problems
What, generally, are myofascial trigger points?
Taut band in the muscle, which refers pain to a distant location when compressed
What happens to muscle fibers with contraction knots?
Knotted area pulls on the remainder of the muscle fiber, causing excessive stretching
What two muscles often refer pain?
Trap and SCM
What causes TrPs?
- Acute overload
- Overwork
- chilling of muscle
- Nerve injuries
What is meant by the term satellite TrPs?
Central TrP induce neurogenically by the activity of a key trigger point
occurs in the referral patterns of the key trigger points
What is a latent TrP?
Clinically quiescent with respect to spontaneous pain
Painful only when palpated
What are active TrPs?
TrPs that cause pain and TTP at rest or with motion that stretches or loads the muscle
Causes shortening of the muscle, as well as fatigue and decreased strength
What is the sequence of events that cause the development of TrPs?
taut bands of muscles, leads to latent TrPs, which are turned actie through stressors
True or false: active TrPs refer pain in a predictive pattern
True
Serratus posterior superior TrP can mimic what spinal level radiculopathy?
C8
The referral pattern of the gluteus minimus TrP mimics what spinal level radiculopathy?
L5 or S1 pain
SCM pain can cause what?
Frontal/occipital HAs
TMJ pain
What is the referral patterns of trap?
Temporalis muscle and posterior scalene
What are the 4 exam findings of TrPs?
- palpable band/taut muscle
- Spot TTP
- Elicited referred pain OR RROM
- Pain recognition
True or false: latent TrPs do not refer pain
False–also refer, but usually require more pressure to do so
What should always be done when assessing TrPs?
Neurological exam
What is the “spectrum of tone”?
Normal to jones pt to latent TrP, to active TrP
What is the role of OMT with TrPs?
Can usually treat acute pain, but chronic pain may need injections
What is the diagnosis if not all 4 criteria are met from TrP Dx?
Latent TrP
What else should be treated with TrPs?
Areas that the area affects
What are the additional treatments that may be utilized with TrPs besides OMT?
- Compression
- Spray and stretch
- Needling of the TrP with lidocaine infiltration
Should you use injections, ischemic compression or spray and stretch with latent TrPs?
No
What is ischemic compression?
Compress for a while to develop ischemia (massage)
How is a spray and stretch performed?
Place muscle on stretch, and direct spray at 4 inches until entire muscle is covered
What are the indications for treating TrPs with injections?
Active TrPs that is:
- Refractory to other treatments OR
- Severe pain/LOF
What is the use of steroids with TrP?
No additional benefit, and are myotoxic
What is the local twitch response?
Involuntary muscle movement when the trigger point is hit with an injection needle
Trigger points should be followed up with what?
Home exercise programs
True or false: Needling without a home stretching program can be highly ineffective
True
How much stretching should be used with TrP injections?
Mild
When should strengthening of the muscle be utilized with TrPs?
Only after treatment
Do active myofascial TrPs cause pain and TTP only with motion, or with rest as well?
Both rest and motion
What happens to the muscles surrounding an active TrP?
Shortening of the muscle, as well as fatigue and decreased strength
