myofascial pain syndromes

..Stretching without prior deactivation may increase TrP sensitivity...

..We speculate that suppressed hippocampal activity might reflect stress-related changes in relation to chronic pain as an effective physical and emotional stressor...

..To investigate the biochemical milieu of the upper trapezius muscle in subjects with active, latent, or absent myofascial trigger points (MTPs) and to contrast this with that of the noninvolved gastrocnemius muscle...

..In this updated pain model, TrPs would be the primary hyperalgesic zones responsible for the development of central sensitization in CTTH...

..Our results indicate that coexistence of FM and TMD with MMP is high. Pain and tenderness in the masticatory muscles appear to be an important element in FM, so in some patients it may be the leading complaint...

..Referred pain and local twitch response reliability varied depending on the muscle being studied...

..Specific research needs are noted. MTrPs are treatable and they deserve increased attention and consideration by research investigators and clinicians...

..This article offers suggestions as to the mechanisms via which LTrP-related pathophysiology may explain the clinical examination findings associated with LTrP-containing and functionally related muscles...

..5 cycles). These significant differences between conditions were found for the right trapezius but not for the left. The findings suggest that high visual stress may be involved in the development of the myofascial pain response...

..This study explores the ability of magnetic resonance elastography to localize and investigate the mechanical properties of myofascial taut bands on the basis of their effects on shear wave propagation...

..The referred pain syndrome can long outlast the initial event, making diagnosis difficult...

..In addition we investigate the recurrence rate during a one-year-follow-up period...

..The aim of this clinical trial was to evaluate the effect of 15 myofascial therapy treatments using ischemic compression on shoulder trigger points in patients with chronic shoulder pain...

..The mechanism of MPS is possibly implicated with the degeneration of motor neurons...

..Although myofascial pain syndromes have been described in the medical literature for about the last 100 years, it is only recently that ..

..It is also important to eliminate any perpetuating factors and provide adequate education and home programs to patients so that recurrent or chronic pain can be avoided...

..The purpose of this study was to determine immediate effects of ischemic compression (IC) and ultrasound (US) for the treatment of myofascial trigger points (MTrPs) in the trapezius muscle...

..Chronic myofascial pain is usually a product of both physical and psychosocial influences that complicate convalescence...

..However, the limited sample size and poor quality of these studies highlights and supports the need for large scale, good quality placebo controlled trials in this area...

..The clinical evidence for and against the common therapeutic interventions used in the management of myofascial pain is reviewed in detail and some tentative conclusions are reached with respect to needling therapies...

..Trigger points are promoted as an important cause of musculoskeletal pain. There is no accepted reference standard for the diagnosis of trigger points, and data on the reliability of physical examination for trigger points are conflicting...

..We propose an expansion of this hypothesis to account for new experimental data and established muscle pathophysiology...

..Active TrPs located ipsilateral to migraine headaches might be a contributing factor in the initiation or perpetuation of migraine...

..The important differences from findings in human studies are that referred pain patterns and the reproduction of pain profile cannot be determined in animals...

..This study provides additional support to the hypothesis that some AcPs are also myofascial trigger points...

..The etiology, pathophysiology, and treatment of myofascial trigger points are addressed in this article...

..Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition...

..To establish whether there is evidence for or against the efficacy of needling as a treatment approach for myofascial trigger point pain...

..Endplate noise seems to be characteristic of, but is not restricted to, the region of a myofascial trigger point...

Interventional therapies are a valuable addition to our armamentarium when treating myofascial pain syndromes. When combined with other therapies, interventional techniques can be an effective adjunct in the multidisciplinary management ..

..To compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome of elderly patients...

..The purpose of this study was to determine the effectiveness of a home program of ischemic pressure followed by sustained stretching for the treatment of myofascial TPs...

..The current evidence does not support the use of BTA injection in trigger points for myofascial pain. The data is limited and clinically heterogeneous...

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..It is also important that the practitioner excludes certain biochemical disorders...

..The goal of this study was to assess clinical consensus regarding whether myofascial pain syndrome (MPS) is a legitimate and distinct diagnosis as well as the signs and symptoms characterizing MPS...

..Mean EMG amplitude in the patient groups was significantly greater than in normals. The authors hypothesize that TrPs are caused by sympathetically activated intrafusal contractions...

..This study was designed to investigate the correlation between the irritability of the myofascial trigger point (MTrP) and the prevalence of endplate noise (EPN) in the MTrP region of human skeletal muscle...

..Early diagnosis and management may also help reduce psychosocial complications and financial burden of chronic pain syndrome...

..To compare the efficacies of dry needling of trigger points (TrPs) with and without paraspinal needling in myofascial pain syndrome of elderly patients...

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..Tenderness and referred pain have been described in migraine and involved in its pathogenesis. The present study was performed to evaluate the prophylactic effectiveness of ropivacaine injections during a 12-week period...

..Existing data suggest that some individuals with FMS may have a dysregulated physiological stress response system that predates the onset of symptoms...

..The purpose of this study was to investigate the effects of tender point dry needling to the trapezius muscles and the resultant changes in muscular hemodynamics...

..CONCLUSIONS: We suggest that the electrical activity arises from a localized zone and is stable over time. SIGNIFICANCE: Our data provide evidence for the reliability and validity of the electrical activity from myofascial tender areas...

..To assess the local and referred pain areas and pain characteristics evoked from temporalis muscle trigger points (TrPs) in chronic tension-type headache (CTTH)...

..We hypothesized that intervention induces pain inhibition via the periaqueductal gray (PAG)...

..The present double-blind, randomized, placebo-controlled, parallel clinical trial studied the effect of BTXA on pain from muscle trigger points and on EMG activity at rest and during voluntary contraction...

..05, all). For example, 4% of video patients were using narcotics at 6 month post ED visit compared with 36% of controls. The brief psycho-educational video had a profound effect on subsequent pain and medical utilization...

..Pressure pain testing that applies stimuli in a random order is associated with improvements in clinical pain, but this association was not stronger than other experimental techniques...

..Our results suggest that spatial summation of perceived pain and mechanical pain sensitivity exists in CTTH patients...

b>Myofascial pain syndromes due to trigger points (TrPs) are clinical entities, but more evidence is needed to evaluate TrP palpation...

..Prospective cohort follow-up study...

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..This finding could be causally related to myalgia or secondary to pain due to deconditioned muscle or altered muscle activity pattern...

b>Myofascial pain syndromes are characterized by the presence of painful loci within muscles, tendons or ligaments, called trigger points. Infiltration of these points with local anesthetics is often used as a treatment modality...

..To screen for the presence of latent and active myofascial trigger points (MTrPs) in patients with unilateral shoulder and arm pain and perform topographical mapping of mechanical pain sensitivity bilaterally in the infraspinatus muscles...

..In the cervicothoracic spine, a misguided or misplaced injection can result in a pneumothorax. Here, we review an electromyographically guided trigger point injection technique to avoid this potential pitfall...

..In addition, we assess the relationship between these muscle TrPs, FHP, neck mobility, and several clinical variables concerning the intensity and the temporal profile of headache...

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..While common, chronic pain is not a normal part of aging, and it should be treated with an emphasis on improved physical function and quality of life...

..The aim of the study was to evaluate the influence of surgical orthognathic correction of facial asymmetries on the intensity of cervicobrachial pain and headache in the short and long term...

..Similar coping strategies were found. Chronic widespread pain without widespread allodynia to pressure pain was found in 4.5% in the population and fibromyalgia in 2.5%...

..These results suggest that latent MTrPs could be involved in the genesis of muscle cramps. Focal increase in nociceptive sensitivity at MTrPs constitutes one of the mechanisms underlying muscle cramps...

..A cluster randomized, controlled trial was performed...

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..CONCLUSION: The significant electromyographic increase from painful areas and no significant increase from control channels are consistent with the view that sympathetic neural outflow increases painful-area electrical activity...

..For 42 patients (91%) the principal cause of the pain was of muscular origin, with frequent features of myofascial pain syndromes (MPS, 50%) and fibromyalgia (FMS, 26%). Pain was the major complaint for 6.3% of the patients...

..Therefore, wind-up after-sensations, tender point count, and negative affect not only seem to represent relevant pain mechanisms but also strongly emphasize their importance for fibromyalgia syndrome pain...

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..The sensitised nociceptors at the fascia of the palpable band might be a possible candidate for the localised tender region...

..CONCLUSIONS: Findings suggest the possibility that botulinum toxin type B may be of potential benefit in the treatment of pain attributed to piriformis syndrome...

..We additionally studied the association of the severity of back pain and both chronic widespread musculoskeletal pain and active tender points...

..A higher density of muscle nociceptors in the vicinity of the motor endplate region may account for the observed differences in pain. These findings may have clinical implications for the treatment of musculoskeletal pain conditions...

..The deep peroneal nerve specifically innervates both the TA muscle and the only site of hyperalgesia indicating spatial summation of afferent activity from these structures...

..Previous studies have suggested the usefulness of botulinum toxin A (BTX-A) in the treatment of MPS since it is capable of controlling muscular spasms, as well as other alternative mechanisms of action...

..The present results suggest an increased excitability of peripheral muscle afferents in TTH...

..These results suggest that migraine pain is often contributed to by myofascial inputs that enhance the level of central neuronal excitability...

..Moreover, Birch concluded that no more than 40% of the acupuncture points examined by Melzack et al. correlated clinically for the treatment of pain (correlation was more like 18%-19%)...

..025) were statistically significant predictors of a positive response to TPI. CONCLUSIONS: This study demonstrates that TPI, in patients who meet criteria for AWP, are effective over the long term...

..Furthermore, there may be site specific central changes reflected by the differences in the results regarding sensitivity and summation over time...

..Thus interventions aimed at reducing local FM pain seem to be effective but need to focus less on tender points but more on trigger points (TrP) and other body areas of heightened pain and inflammation...

..Thus, myofascial pain of the PQ should be considered as a possible cause of pain in the medial forearm and hand, especially when no other neurological abnormalities are present...

..Another problem regarding HBO is the scarcity of centers administering it. Further research is required focusing on the optimal treatment protocol, the cost/benefit ratio, and the safety of HBO in chronic pain management...

..Increased sensitivity in nociceptive pathways from cephalic region may be of importance in the pathophysiology of chronic tension type headache...

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..include cervical dystonia, pelvic pain, low back pain, plantar fasciitis, postsurgical painful spasms, myofascial pain syndromes, migraine, and chronic daily headaches...

..To develop psychophysical measures to facilitate diagnosis of pelvic floor myofascial pain syndromes, this pilot was designed to preliminarily test the feasibility, reliability, and validity of pressure-..

..The aim of this review is to evaluate the evidence for laser acupuncture in selected orthopaedic diseases...

..Female patients with (1) FS+myofascial pain syndromes from trigger points (n=68), or (2) FS+joint pain (n=56) underwent evaluation of myofascial/joint ..

..Chronic musculoskeletal complaints are common in the clinical setting and a therapeutic challenge. Little is known about the extent and type of pain-relieving drugs used by these patients in Norway...

..of clinical presentations exists, ranging from focal or regional complaints that usually represent myofascial pain syndromes to more wide spread pain that may meet criteria for a diagnosis of fibromyalgia...

..On the other hand, local injection of prilocaine alone exerted a shorter and weaker effect on the condition...

..The main diagnosis is a musculoskeletal disorder in more than one third. The aim of this study was to investigate the health condition of those who apply for disability pension due to musculoskeletal complaints...

Acupuncture has been successfully used in myofascial pain syndromes. However, the number of needles used, that is, the dose of acupuncture stimulation, to obtain the best antinociceptive efficacy is still a matter of debate...

..Many common chronic musculoskeletal pain syndromes - including regional myofascial pain syndromes, whiplash pain syndromes, refractory work-related neck-shoulder pain, certain types of chronic low back ..

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..There is a strong institutional commitment to see the applicant succeed in this task due to a tremendous need for well-trained clinical investigators in alternative and complementary medicine. ..

..In addition, our findings may contribute to the understanding of pain mechanisms related to other chronic pain disorders. ..

..Either way, we will provide evidence that will characterize the role of local anesthesia, placebo analgesia, or both. Thus patients with FM and other similar pain syndromes may strongly benefit from the results of our study. ..

..Either way, we will provide evidence that will characterize the role of local anesthesia, placebo analgesia, or both. Thus patients with FM and other similar pain syndromes may strongly benefit from the results of our study. ..

..Either way, we will provide evidence that will characterize the role of local anesthesia, placebo analgesia, or both. Thus patients with FM and other similar pain syndromes may strongly benefit from the results of our study. ..

..Our approach would also be broadly applicable to elucidating the underlying mechanisms in other chronic musculoskeletal pain disorders, such low back pain. ..

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..In addition, mechanisms of action will be explored, and the impact of osteopuncture on health care costs determined. ..

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..This understanding is expected to support our long-term goal of improving clinical treatment of MFP by targeting treatment to underlying pain-maintenance mechanisms. ..

..If only FMS probands have familial M/TMD but M/TMD probands do not, this will support the 2nd hypothesis and indicate that the two disorders are provoked through different pathogenic processes. ..