In this article, we will discuss the Clinical Features and Pathophysiology of Myofascial Pain Syndrome. So, let’s get started.
Myofascial Pain Syndrome is characterized by:
Trigger points (usually in mid-portion or belly of the affected muscle)
A Taut band (<1 cm2)
Local twitch response followed by “Snapping Palpation”
Disturbed sensation in a predicted location
Restricted range of motion
Pathophysiology (>> means next step)
Acute muscle strain>> Tissue damage>> Tears in Sarcoplasmic Reticulum>> Free Ca++>> Sustained contraction>> Increased strain on vulnerable areas>> Free Ca++>> Local hypermetabolic state and vasoconstriction.
In this article, we will discuss about Myofascial trigger points. So, let’s get started.
Myofascial trigger points
Myofascial trigger points are discrete, focal, hyperirritable or hypersensitive soft tissue areas/spots (taut like band) that are felt like palpable nodules. They produce pain locally or in a referred pattern often acompanied by chronic musculokeletal disorders. Repetitive stress, acute trauma or microtrauma often leads to developoment of myofascial trigger points. Symptoms includes persistent pain (localized or referred), tenderness of the affected region, and decreased range of motion of the affected muscle. On palpation the trigger points are felt harder than normal consistency, nodular, and occasionally tender. Management includes Spray and Stretch technique, Trigger point pressure release technique, Myofascial release therapy, and Trigger point injection such as dry needling are some of the effective treatment modalities for trigger point pain relief.
Diiferent types of trigger points
Primary and Secondary/Central and Satellite trigger points
Primary or Central trigger points are local trigger points which when palpated produces pain. Specific characteristics includes that they are well-established, high intensity pain zone, and are present at or in the vicinity of neuromuscular junction.
Secondary or Satellite trigger points are present in the neighbouring areas of the central trigger points within the referred pain zone.
Active and Latent trigger points
Active trigger points can be applied to both central and satellite trigger points, they are tender to palpation and elicits a referred pain pattern. Pain can limit range of motion
Latent trigger points are not painful and do not elicits any referred pain. Although their presence leads to increased muscle tension/tighteness and stiffness. Force palpation or stimulation such force muscular activity or trauma or acute injury can re-activate an inactive trigger point.
We will further differentiate between active and latent trigger points as stated below