November 2, 2015 - Myofascial Pain Syndrome

Question 1

Myofascial Pain Syndrome

Answer 1

Is a syndrome cahracterized by chronic pain in multiple myofascial trigger points and fascial constrictions.

Characteristic features of a myofascial trigger point include focal point tenderness, reproduction of pain upon trigger point palpation, hardening of the muscle upon trigger point palpation, pseudo-weakness of the involved muscle, referred pain, and limited range of motion following 5 seconds of sustained trigger point pressure.

Question 2

“Major” Criteria

Answer 2

Spot tenderness in taut band with firm pressure applied for ~5 seconds

Expected distribution of referred pain from a myofascial TrP

Taut band in accessible muscle

Regional pain complaint

Restricted ROM when measurable

Question 3

Latent Trigger Points

Answer 3

Stiffness with restricted range of motion

Only tender on palpation; no spontaneous pain

Question 4

Active Trigger Points

Answer 4

Spontaneous pain + referred pain characteristic of a patient’s pain on palpation.

Question 5

Dynamic Trigger Points

Answer 5

May change from being a non-tender taut band, to a latent trigger point, to an active trigger point.

These are all dynamic.

Question 6

Integrated Trigger Point Hypothesis

Answer 6

Injury to muscle can cause an increased ACh transmission which can lead to contraction. Prolonged contraction can cause hypoxia, which can eventually cause peripheral nociceptor sensitization.

Question 7

Causes of MPS

Answer 7

Assymetry

Imbalance

Overload

Question 8

Sciatica

Answer 8

Is a symptom, not a cause.

Question 9

Treatment of Trigger Points

Answer 9

Massage therapy

Stretching

Myofascial injections

Dry needling

Question 10

Sacroiliac Joint

Answer 10

Transfers load between the trunk and the lower extremities during both static and dynamic activities.

It is essentially a keystone.