Myofascial trigger point therapy
benefit information and treatment
January 23 2016
Myofascial trigger point therapy is a type of bodywork which tries to release muscular tension by applying pressure to trigger points, areas of the muscle which hold pain and tension. This type of bodywork is also sometimes referred to as myofascial release or trigger point therapy. Myofascial trigger point therapy and acupuncture have many similar trigger points.
History of myofascial trigger point therapy
The principles of myofascial trigger point therapy began to take shape in the West in the 1800s, and evolved in the 20th century into its current form. It is based on the concept that the muscles and connective tissue covering them -- the fascia -- have specific hyper-irritable areas, or trigger points, that produce pain in the immediate area or elsewhere in the body (called referred pain). Physical therapists, chiropractors and other practitioners use various methods to relieve pain at these trigger points, including massage, deep pressure, electrical stimulation and stretching. Acupuncture and myofascial trigger point therapy focus on stimulating specific points on the body to treat pain. There are 361 classical acupuncture points, and 255 trigger points in myofascial pain therapy. The majority of these trigger points correspond anatomically with acupuncture points. In the treatment of pain disorders, acupuncture and myofascial techniques are quite similar. Journal of Alternative and Complementary Medicine, 2008.
Discrepancy between prevalence and perceived
effectiveness of treatment methods in myofascial pain syndrome: Results of a
cross-sectional, nationwide survey.
BMC Musculoskelet Disord. 2010; Fleckenstein J, Ruger LJ, Lehmeyer L, Freiberg F, Lang PM, Irnich D.
Myofascial pain is a common dysfunction with a lifetime prevalence affecting up to 85% of the general population. Current guidelines for the management of myofascial pain are not available. In this study we investigated how physicians on the basis of prescription behaviour evaluate the effectiveness of treatment options in their management of myofascial pain. We conducted a cross-sectional, nationwide survey with a standardized questionnaire among 332 physicians experienced in treating patients with myofascial pain. Recruitment of physicians took place at three German meetings of pain therapists, rheumatologists and orthopaedists, respectively. Physicians estimated the prevalence of myofascial pain amongst patients in their practices, stated what treatments they used routinely and then rated the perceived treatment effectiveness on a six-point scale (with 1 being excellent). Data are expressed as mean +/- standard deviation. The estimated overall prevalence of active myofascial trigger points is 46%. Frequently prescribed treatments are analgesics, mainly metamizol/paracetamol (91%), non-steroidal anti-inflammatory drugs/coxibs (87%) or weak opioids (81%), and physical therapies, mainly manual therapy (81%), TENS (72%) or acupuncture (60%). Overall effectiveness ratings for analgesics and physical therapies were moderate. Effectiveness ratings of the various treatment options between specialities were widely variant. 54.3% of all physicians characterized the available treatment options as insufficient. Myofascial pain was estimated a prevalent condition. Despite a variety of commonly prescribed treatments, the moderate effectiveness ratings and the frequent characterizations of the available treatments as insufficient suggest an urgent need for clinical research to establish evidence-based guidelines for the treatment of myofascial pain syndrome.
PM R. 2015. Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. tThe intent of this article is to discuss the evolving role of the myofascial trigger point (MTrP) in myofascial pain syndrome (MPS) from both a historical and scientific perspective. MTrPs are hard, discrete, palpable nodules in a taut band of skeletal muscle that may be spontaneously painful (i.e., active) or painful only on compression (i.e., latent). MPS is a term used to describe a pain condition that can be acute or, more commonly, chronic and involves the muscle and its surrounding connective tissue (e.g. fascia). According to Travell and Simons, MTrPs are central to the syndrome-but are they necessary? Although the clinical study of muscle pain and MTrPs has proliferated over the past two centuries, the scientific literature often seems disjointed and confusing. Unfortunately, much of the terminology, theories, concepts, and diagnostic criteria are inconsistent, incomplete, or controversial. To address these deficiencies, investigators have recently applied clinical, imaging (of skeletal muscle and brain), and biochemical analyses to systematically and objectively study the MTrP and its role in MPS. Data suggest that the soft tissue milieu around the MTrP, neurogenic inflammation, sensitization, and limbic system dysfunction may all play a role in the initiation, amplification, and perpetuation of MPS.