Differential Diagnosis of Trigger Points

Abstract

SUMMARYObjective: A number of medical and structural conditions produce muscular pain associated with myofascial trigger points [TrPs]. These conditions should be considered when evaluating a patient with muscle pain.Thesis: Myofascial pain syndrome is characterized by regional or widespread myalgia with muscle TrPs. Trigger points are also common in fibromyalgia. The TrP is a physical sign that occurs in a variety of myalgic conditions. Acute or chronic muscle stress creates an “energy crisis” that can result in a TrP. A muscle-related nociceptive stimulation of the peripheral and central nervous system results in hypersensitivity. Both mechanical and systemic medical disorders stress muscle. Mechanical problems can be structural or postural. Static [postural] or acute [trauma] muscle overload occurs in mechanical disorders which results in physical and biochemical changes including hypoxia and ischemia, and neuromuscular junction dysfunction. Delayed onset muscle pain is seen in unaccustomed eccentric e...