Key Chapter Points:
-
Myofascial pain should be considered in patients with localized pain complaints without arthritic or neuropathic features.
-
Myofascial pain syndrome should not be diagnosed in patients with no physical findings. Myofascial pain requires the presence of a taut band and muscular trigger points.
-
Active trigger points refer pain in predictable patterns.
-
Treatment of myofascial pain focuses on active stretching and range of motion exercises. Physical therapy modalities, injections, and medications may be used adjunctively.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Simons DG, Travell JG, Simons LS. Myofascial Pain and Dysfunction: The Trigger Point Manual, vol. 1, Ed 2. Baltimore: Lippincott Williams & Wilkins, 1999
Hubbard DR, Berkoff GM. Myofascial trigger points show spontaneous needle EMG activity. Spine 1993;18:1803–1807
Shah JP, Phillips TM, Danoff JV, Gerber LH. An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol 2005;99:1977–1984
Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil 2008;89:16–23
Shootsky SA, Jaeger B, Oye RK. Prevalence of myofascial pain in general internal medicine practice. West J Med 1989;151:157–160
Gam AN, Warming S, Larsen LH, et al. Treatment of myofascial trigger-points with ultrasound combined with massage and exercise – a randomized controlled trial. Pain 1998;77:73–79
Chuen-Ru H, Tsai L, Cheng K, Chung K, Hong C. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Arch Phys Med Rehabil 2002;83:1406–1414
Edwards J, Knowles N. Superficial dry needling and active stretching in the treatment of myofascial pain – a randomized controlled trial. Acupunct Med 2003;21:80–86
Hsieh YL, Kao MJ, Kuan TS, et al. Dry needling to a key myofascial trigger point may reduce the irritability of satelitte MTrPs. Am J Phys Med Rehabil 2007;86:397–403
Ga H, Choi J, Park C, Yoon H. Acupuncture needling versus lidocaine injection of trigger points in myofascial pain syndrome in elderly patients – a randomized trial. Acupunct Med 2007;25:130–136
Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil 1994;73:256–263
Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil 2001;82:986–992
Göbel H, Heinze A, Reichel G, Hefter H, Benecke R. Efficacy and safety of a single botulinum type A toxin complex treatment (Dysport) for the relief of upper back myofascial pain syndrome: results from a randomized double-blind placebo-controlled multicentre study. Pain 2006;125:82–88
Qerama E, Fuglsang-Frederiksen A, Kasch H, Bach FW, Jensen TS. A double-blind, controlled study of botulinum toxin A in chronic myofascial pain. Neurology 2006;67:241–245
Lew HL, Lee EH, Castaneda A, Klima R, Date E. Therapeutic use of botulinum toxin type A in treating neck and upper back pain of myofascial origin: a pilot study. Arch Phys Med Rahabil 2008;89:75–80
Hord AH, Chalfoun AG, Denson DD, Azevedo MI. Systemic tizanidine hydrochloride (Zanaflex) relieves thermal hyperalgesia in rats with an experimental mononeuropathy. Anesth Analg 2001;93:1310–1315
Malanga GA, Gwynn MW, Smith R, Miller D. Tizanidine is effective in the treatment of myofascial pain syndrome. Pain Physician 2002;5:422–432
Matzke GR. Nonrenal toxicities of acetaminophen, aspirin and nosteroidal anti-inflammatory agents. Am J Kidney Dis 1996;28 (Suppl 1):S63–S70
Gambaro G, Perazella MA. Adverse renal effects of anti-inflammatory agents: evaluation of selective and nonselective cyclooxygenase inhibitors. J Intern Med 2003;253:643–652
Bogart RK, McDaniel RJ, Dunn WJ, et al. Efficacy of group cognitive behavior therapy for the treatment of masticatory myofascial pain. Mil Med 2007;172:169–174
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer Science + Business Media, LLC
About this chapter
Cite this chapter
Marcus, D.A. (2009). Myofascial Pain. In: Chronic Pain. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-60327-465-4_11
Download citation
DOI: https://doi.org/10.1007/978-1-60327-465-4_11
Publisher Name: Humana Press
Print ISBN: 978-1-60327-464-7
Online ISBN: 978-1-60327-465-4
eBook Packages: MedicineMedicine (R0)