Prevalence Of Myofascial Trigger Points Research Articles

Prevalence of Myofascial Trigger Points in Isolated Idiopathic Cervical Dystonia: A Possible Contributor to Pain, Movement and Disability.

Myofascial trigger points (TrPs) are hypersensitive points located in a tight band of muscle that, when palpated, produce not only local pain but also referred (distant) pain. The role of TrPs in patients with cervical dystonia (CD) has not been investigated. To identify the presence of TrPs in patients with isolated idiopathic CD and their association with pain. Thirty-one patients (74.2% women; age: 61.2 years, SD: 10.1 years) participated. TrPs were explored in the sternocleidomastoid, upper trapezius, splenius capitis, levator scapulae, anterior scalene, suboccipital, and infraspinatus muscles. Clinical features of CD were documented as well as the presence of pain. The severity of dystonia and its consequences were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). The mean number of TrPs for each patient was 12 (SD:3), with no differences between patients with pain (n = 20) and those without pain (n = 11). Active TrPs were only found in patients with pain (mean: 7.5, SD:4). Latent TrPs were found in both groups but were more prevalent (P < 0.001) in patients without pain (mean: 11, SD:3.5) than in those with pain (mean: 5, SD:3.5). The number of active TrPs or latent TrPs was positively associated with the TWSTRS disability subscale and the TWSTRS total score. The number of active, but not latent, TrPs was associated with worse scores on the TWSTRS pain subscale. Active TrPs were present in patients with CD reporting pain, while latent TrPs were present in all CD patients, irrespective of their pain status. The numbers of active/latent TrPs were associated with disability. TrPs could act as pain generators in CD and also contribute to the involuntary muscle contractions characteristic of dystonia.

Neck pain repercussions in migraine – The role of physiotherapy

IntroductionMigraine is a neurological and disabling disease whose peripheral manifestations can be addressed with physiotherapy. These manifestations can include pain and hypersensitivity to muscular and articular palpation in the neck and face region, a higher prevalence of myofascial trigger points, limitation in global cervical motion, especially in the upper segment (C1–C2), and forward head posture with worse muscular performance. Furthermore, patients with migraine can present cervical muscle weakness and greater co-activation of antagonists in maximum and submaximal tasks. In addition to musculoskeletal repercussions, these patients can also present balance impairment and a greater risk of falls, especially when chronicity of migraine frequency is present. The physiotherapist is a relevant player in the interdisciplinary team and can help these patients to control and manage their migraine attacks. PurposeThis position paper discusses the most relevant musculoskeletal repercussions of migraine in the craniocervical area under the perspective of sensitization and disease chronification, besides addressing physiotherapy as an important strategy for evaluating and treating these patients. ImplicationsPhysiotherapy as a non-pharmacological treatment option in migraine treatment may potentially reduce musculoskeletal impairments related to neck pain in this population. Disseminating knowledge about the different types of headaches and the diagnostic criteria can support physiotherapists who compose a specialized interdisciplinary team. Furthermore, it is important to acquire competencies in neck pain assessment and treatment approaches according to the current evidence.

Myofascial Pain Syndrome in Women with Primary Dysmenorrhea: A Case-Control Study.

There is limited information on myofascial trigger points (MTrPs) and specific symptoms of chronic pelvic pain and, more specifically, dysmenorrhea. The objective of this study was to determine whether patients suffering from primary dysmenorrhea present alterations in mechanosensitivity and pain patterns, and greater presence of MTrPs in the abdominal and pelvic floor muscles. A case-control study was carried out with a total sample of 84 participants distributed based on primary dysmenorrhea and contraceptive treatment. The sample was divided into four groups each comprising 21 women. Data on pain, quality of life, and productivity and work absenteeism were collected; three assessments were made in different phases of the menstrual cycle, to report data on pressure pain threshold, MTrP presence, and referred pain areas. One-way ANOVA tests showed statistically significant differences (p &lt; 0.01) between the groups, for the Physical Health domain and the total score of the SF-12 questionnaire, and for all the domains of the McGill questionnaire; but no significant differences were found in the data from the WPAI-GH questionnaire. Statistically significant data (p &lt; 0.01) were found for mechanosensitivity in the abdominal area and limbs, but not for the lumbar assessment, within the group, with very few significant intergroup differences. The frequency of active MTrPs is higher in the groups of women with primary dysmenorrhea and during the menstrual phase, with the prevalence of myofascial trigger points of the iliococcygeus muscle being especially high in all examination groups (&gt;50%) and higher than 70% in women with primary dysmenorrhea, in the menstrual phase, and the internal obturator muscle (100%) in the menstrual phase. Referred pain areas of the pelvic floor muscles increase in women with primary dysmenorrhea.

Myofascial trigger points in subjects with non-specific neck pain

Background: In recent years, non-specific neck pain has become a frequent complaint due to poor head postures. It is characterized by Myofascial Trigger Points (MTrPs) in palpable taut bands of skeletal muscle that refer pain to a distance, and that can cause distant motor and autonomic effects.&#x0D; Objective. The aim of the study was to assess the prevalence of active and latent MTrPs in subjects suffering from non-specific neck pain in two hospitals, Sri Lanka.&#x0D; Method: This cross- sectional descriptive study was carried out among 31 patients with non-specific neck pain, presented to the department of physiotherapy, Teaching Hospital Peradeniya and National Hospital, Kandy, Sri Lanka. Participants were referred by a physician for non-specific neck pain and MTrPs were determined by a physiotherapist. MTrPs diagnosis criteria were the presence of a palpable taut band in a skeletal muscle; presence of a hyper-sensible tender spot in the taut band; local twitch response; reproduction of the referred pain pattern in response to compression; and spontaneous presence of the typical referred pain pattern and/or patient recognition.&#x0D; Results. The prevalence of MTrPs among patients with non-specific neck pain was 100%. Each of the 31 patients exhibited at least two MTrPs in the analyzed muscles. The mean number of MTrPs on each patient was 4.71± 2.036. MTrPs of the upper trapezius muscles were the most prevalent, in 96.8% of the participants. MTrPs in the suboccipital muscles, sternocleidomastoid, levator scapulae reached a prevalence of 58.1%, 45.2%, 35.5% respectively. 76.74% of total number of MTrPs in all analyzed muscles were active MTrPs.&#x0D; Conclusions. MTrP is a common source of pain in subjects presenting non-specific neck pain. Our study determined the presence of both active and latent MTrPs in this population with a higher prevalence of active MTrPs compared to latent MTrPs in all individual muscles.

Association of myofascial trigger points in neck and shoulder region with depression, anxiety and stress among university students.

To determine the prevalence of myofascial trigger points in the shoulder and neck region, and to assess association with depression, anxiety and stress. The cross-sectional study was conducted from January to September 2019 at Riphah International University, Faisalabad, Pakistan, and comprised students from different universities in Faisalabad. Myofascial trigger points were identified among the subjects using palpation method by a therapist. Depression anxiety stress scale was used to determine the level of depression, anxiety and stress. Data was analysed using SPSS 20. Of the 2000 subjects, 970(49%) were male and 1030(52%) were female. The overall age range was 18-25 years. Myofascial trigger points were present in 1727(86.4%) subjects and absent in 273(13.7%). The trigger points had significant association with depression, anxiety and stress (p<0.001). Myofascial trigger points were quite common among university students and were associated with depression, anxiety and stress.

Comparison of the prevalence of myofascial trigger points of muscles acting on knee between patients with moderate degree of knee osteoarthritis and healthy matched people

IntroductionTrigger points have been implicated in the development of several musculoskeletal disorders. Trigger points harbored in lower limb muscles might represent a ubiquitous source of pain in patients with knee osteoarthritis (OA). This study was carried out to evaluate the prevalence of Myofascial Trigger Points (MTrPs) in muscles acting on the knee in patients with OA. MethodsThirty-seven patients aged at least 55 years old with a moderate degree of OA (grade III of Kellgren and Lawrence scale) were recruited. Thirty asymptomatic people, matched on age and body mass index, were considered as the control group. Ten muscles acting on the knee joint were selected. Taut bands were also identified using a skin rolling method. A pressure of 3 kg/cm2 was used to identify myofascial trigger points in all muscles except the popliteus (8 kg/cm2). ResultsChi-square was performed to compare the prevalence of trigger points between the groups. The McNemar test was administered to compare the prevalence of trigger points in the right and left sides of participants. Prevalence of the trigger points was significantly higher in patients with knee OA compared with asymptomatic people in all muscles except for right (p = 0.17) and left (p = 0.41) rectus femoris, right (p = 0.61) and left (p = 0.22) sartorius and left biceps femoris (p = 0.08). Comparison of the prevalence of MTrPs bilaterally revealed that only the right and left sartorius differed significantly (p = 0.008). ConclusionsThe prevalence of MTrPs in the muscles acting on the knee joint is higher in patients with a moderate degree of knee OA compared with asymptomatic subjects.

Prevalence of Myofascial Trigger Points in Patients with Mild to Moderate Painful Knee Osteoarthritis: A Secondary Analysis.

Objective: To determine the prevalence of myofascial trigger points (MTrPs) and the correlation between the number of MTrPs and pain and function in patients presenting knee pain osteoarthritis (OA). Methods: This was a secondary analysis of data from a cross-sectional study. The prevalence of MTrPs located in tensor fasciae latae, hip adductors, hamstrings, quadriceps, gastrocnemius, and popliteus muscles was studied in 114 patients (71 men and 43 women) with knee OA. Pain and functionality were assessed with a numerical pain rating scale (NPRS), the Western Ontario, McMaster Universities Osteoarthritis Index (WOMAC) score, the Barthel Index, and the timed up and go test. Results: The prevalence of latent MTrPs was detected via palpation and was estimated to be 50%, 35%, 25%, 29%, 33%, and 12% for tensor fasciae latae, hip adductors, hamstrings, quadriceps, gastrocnemius, and popliteus muscles, respectively. The prevalence of active MTrPs was estimated to be 11%, 17%, 30%, 18%, 25%, and 17% for tensor fasciae latae, hip adductors, hamstrings, quadriceps, gastrocnemius, and popliteus muscles, respectively. Pain was measured with the NPRS scale and was poorly correlated with the prevalence of latent MTrPs (r = 0.2; p = 0.03) and active MTrPs (r = 0.23; p = 0.01) in the hamstrings. Disability was moderately correlated with the number of latent MTrPs in the tensor fasciae latae muscle (Barthel, r = 0.26; p = 0.01 and WOMAC, r = 0.19; p = 0.04). Conclusions: This secondary analysis found that the prevalence of the MTrPs varied from 11% to 50% in different muscles of patients with mild to moderate painful knee osteoarthritis. Pain was correlated poorly with the prevalence of latent and active MTrPs in the hamstring muscles, and disability correlated moderately with the number of latent MTrPs in tensor fasciae latae.

The Interexaminer Reproducibility and Prevalence of Lumbar and Gluteal Myofascial Trigger Points in Patients With Radiating Low Back Pain

ObjectiveTo determine the interexaminer reproducibility for judging the presence, number, and location of leg-pain referring myofascial trigger points, and their prevalence in patients with low back pain with and without concomitant leg pain referral. DesignAn interexaminer reproducibility study. SettingAn outpatient public Hospital Spine Centre in Southern Denmark. ParticipantsExaminers: experienced examiners (N=2), a chiropractor and a physiotherapist, respectively. Subjects: a case mix of patients with low back pain (N=32) with and without leg pain referral. InterventionsA standardized palpation examination protocol of 4 bilateral lumbosacral muscles performed by each examiner. Main Outcome MeasuresReproducibility on presence (measured in Cohen’s κ), number (difference and limits of agreement), location (distance between matching marks placed by examiners), and prevalence of myofascial trigger points. ResultsKappa values of the examined muscles were as follows: quadratus lumborum (κ=0.42), gluteus medius (κ=0.83), gluteus minimus (κ=0.74), and piriformis (κ=0.62), with a mean of all examined muscles of kappa=0.66, assessed as substantial agreement. The mean difference in number of trigger points was 0.8, with limits of agreement ranging from −6.4 to 4.9. Mean distance between trigger point locations was 12.9 mm, with 57% only being identified by a single examiner. The prevalence of trigger points was 82.7%, highest in the gluteal region of the painful side. ConclusionsInadequate standardization and multiple trigger point sites complicate interexaminer reproducibility on location and number of patients with low back pain and leg pain referral. Nevertheless, substantial interexaminer reproducibility for the trigger point presence appears achievable. Implemented routinely, this relatively simple clinical evaluation procedure could meaningfully enhance diagnostic triage and eventual management.

Prevalence of Myofascial Trigger Points in Brachioradialis, Biceps Brachii, Triceps Brachii, Supinator and Extensor Carpi Radialis Brevis in Lateral Epicondylitis

Introduction– Myofascial pain syndrome (MPS) is a myalgic condition in which muscle andmusculotendinous pain are the primary symptoms. Some muscles are likely to develop Myofascial triggerpoints in cases of lateral epicondylitis and become possible cause of mainstay of symptoms. Hence thestudy was undertaken to find the prevalence of myofascial trigger points in such muscles.Methodology & Results – 40 individuals aged between 20-50 years fulfilling the inclusion criteria wereselected for the study with acute and chronic lateral epicondylitis. Brachioradialis, Biceps Brachii, TricepsBrachii, Supinator and Extensor carpi radialis brevis were checked for the presence of trigger point bypalpation. Pressure algometer was used to check the pain threshold of each point. When the subject reportsfeeling pain the action of pressure is stopped and reading is recorded.Results showed a higher prevalence in females than males. The most prevalent area for trigger point wasthe brachioradialis followed by biceps brachii, extensor carpi radialis, triceps brachii and the least prevalentwas the supinator.Conclusion - This study provides that the relation between myofascial trigger points in lateral epicondylitisis relatively high especially in Brachioradialis, It also shows that latent trigger points don’t lead to severefunctional disability.

Prevalence and sensitivity of trigger points in lumbo-pelvic-hip muscles in patients with patellofemoral pain syndrome

ObjectivesChanges in the activity of the lumbo-pelvic-hip muscles have been established as a major cause of patellofemoral pain syndrome (PFPS), a common orthopedic problem. The present study aimed to compare the prevalence and sensitivity of myofascial trigger points (MTrPs) in lumbo-pelvic-hip muscles in persons with and without PFPS. MethodsThirty women with PFPS and 30 healthy women 18–40 years old were recruited for this study. The prevalence of MTrPs was assessed by palpation, and pressure algometry was used to measure the pressure pain threshold. This study evaluated the areas where MTrPs are most commonly found in the lumbar muscles (internal oblique, erector spinae and quadratus lumborum), pelvic muscles (gluteus maximus, gluteus medius, gluteus minimus and piriformis), and hip muscles (hip adductor, quadriceps, hamstring, tensor fascia lata and sartorius). Independent t-tests were used to compare mean pressure pain thresholds between the two groups. Chi-squared tests were used to compare the prevalence of MTrPs. ResultsThe prevalence of MTrPs was significantly higher in most of the lumbo-pelvic-hip muscles in patients with PFPS compared to healthy persons. However, there were no significant differences between groups in the prevalence of MTrPs in the gluteus minimus or adductor muscles. The pressure pain threshold in lumbo-pelvic-hip muscles was lower in patients with PFPS compared to healthy participants. ConclusionIn patients with PFPS the prevalence of MTrPs in the lumbo-pelvic-hip region was higher, and the pressure pain threshold was lower, than in healthy people. Thus therapy to treat PFPS should target the lumbo-pelvic-hip muscles.

The prevalence of myofascial trigger points in hip and thigh areas in anterior knee pain patients

BackgroundAnterior knee pain (AKP) is a widespread problem among young athletes and soldiers. There are many theories on the etiology of AKP but there is little reference to myofascial trigger points (MTrPs) as a possible contributor. AimTo evaluate the association between AKP and prevalence of active and latent MTrPs in the hip and thigh muscles in soldiers. MethodsA cross-sectional study was conducted in the Beer-Sheva military outpatient physical therapy clinic. Subjects were 42 men and 23 women referred for physical therapy, 33 with a diagnosis of AKP (cases) and 32 with upper limb complaints (without AKP, controls). All subjects underwent physical evaluation by an examiner blinded to their identity and medical condition. The following muscles were assessed bilaterally for active or latent MTrPs: rectus femoris (proximal), vastus medialis (middle and distal), vastus lateralis (middle and distal) and gluteus medius (anterior, posterior and distal). ResultsIn six out of eight areas, the cases had a higher prevalence of total active and latent MTrPs than the controls. When summarizing MTrPs by muscle, cases had significantly more MTrPs than controls in each muscle. The largest difference was found in vastus medialis and vastus lateralis; nearly half of the cases had MTrPs in these muscles. ConclusionsSubjects with AKP have a greater prevalence of MTrPs in their hip and thigh muscles than controls, indicating an association between MTrPs and AKP. Further research is necessary to determine whether MTrPs are the cause or the consequence of AKP.

Prevalence of Myofascial Trigger Points in Poststroke Patients With Painful Shoulders: A Cross-Sectional Study.

In patients with stroke, hemiplegic shoulder pain can be a major problem. One source of shoulder pain can be myofascial trigger points (MTrPs). To determine the prevalence of myofascial trigger points (MTrPs) and the correlation between MTrPs and pain and function in patients presenting with shoulder pain following a stroke. Cross-sectional study. Department of Physical Therapy. Fifty patients with stroke with shoulder pain. Not applicable. The prevalence of the MTrPs located in infraspinatus, supraspinatus, teres minor, and upper trapezius was studied, using the diagnosis criteria recommended by Simons et al. The pressure pain threshold was also evaluated. Pain and function were assessed with the Visual Analogue Scale (VAS) and the Disability of the Arm, Shoulder and Hand (DASH) scale, respectively. The prevalence of latent MTrPs was 68%, 92%, 40%, and 62% for supraspinatus, infraspinatus, teres minor, and upper trapezius muscle, respectively. The prevalence of active MTrPs was 34%, 50%, 12%, and 20% for supraspinatus, infraspinatus, teres minor, and upper trapezius muscle, respectively. Pain was moderately correlated with the prevalence of latent MTrPs (r = 0.35; P = .01) and active MTrPs (r = 0.31; P = .03) in the supraspinatus muscle. Disability was measured with the DASH scale and was moderately correlated with latent MTrPs in the infraspinatus (r = 0.31; P = .03) and active MTrPs of the supraspinatus (r = 0.32; P = .02). This study shows that the prevalence of MTrPs is high in patents following a stroke. MTrPs in this population are moderately associated with pain and function. II.

Prevalence of Myofascial Trigger Points of Gastrocnemius in Dancers

Myofascial trigger points are hyperirritable spot which is usually a taut band of skeletal muscle, which is painful on compression and give rise to musculoskeletal dysfunction. Gastrocnemus muscle being the main muscle of mobility and stabilty in dancers. Due to this constant use of this muscle in various dance forms and the fatigue caused, it may cause trigger points. Objective To study the occurrence of trigger points in dancers. To study prevalence of trigger points in various dance forms and finding out which dance form dancers have high prevalence for trigger point. To study the correlation of presence of trigger point and strength of the gastrocnemius muscle. Materials and Methodology This is an observational study comprising of 100 samples who were trained dancers. Dancers of bharatnatayam, kathak and contemporary form were included and were palpated for trigger points, which were then presented in tabular and graphical manner. Results and Conclusion Results showed 52 % have trigger point in gastrocnemius and 48% did not have trigger point in gastrocnemius. Out of the 3 dance forms selected, bharatnatayam dancers showed more prevalence of trigger point of gastrocnemius.

The prevalence of myofascial trigger points in neck and shoulder-related disorders: a systematic review of the literature

BackgroundNeck and shoulder disorders may be linked to the presence of myofascial trigger points (MTrPs). These disorders can significantly impact a person’s activities of daily living and ability to work. MTrPs can be involved with pain sensitization, contributing to acute or chronic neck and shoulder musculoskeletal disorders. The aim of this review was to synthesise evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders.MethodsWe conducted an electronic search in five databases. Five independent reviewers selected observational studies assessing the prevalence of MTrPs (active or latent) in participants with neck or shoulder disorders. Two reviewers assessed risk of bias using a modified Downs and Black checklist. Subject characteristics and prevalence of active and latent MTrPs in relevant muscles was extracted from included studies.ResultsSeven articles studying different conditions met the inclusion criteria. The prevalence of MTrPs was compared and analysed. All studies had low methodologic quality due to small sample sizes, lack of control groups and blinding. Findings revealed that active and latent MTrPs were prevalent throughout all disorders, however, latent MTrPs did not consistently have a higher prevalence compared to healthy controls.ConclusionsWe found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders. Point prevalence estimates of MTrPs were based on a small number of studies with very low sample sizes and with design limitations that increased risk of bias within included studies. Future studies, with low risk of bias and large sample sizes may impact on current evidence.

Active myofascial trigger points in head and neck muscles of patients with chronic tension-type headache in two primary health care units in Tshwane

Background: The management of patients presenting with chronic tension-type headache (CTTH) can be challenging for primary health care practitioners. As with most chronic pain disorders, a multimodal management approach is frequently required. It has been postulated that myofascial pain syndrome (MPS) and its hallmark myofascial trigger points (MTrPs) found in specific muscle tissues may play a role in the chronic pain experienced by patients with CTTH. Little is known about the prevalence of MTrPs in patients with CTTH, in primary health care settings on the African continent. This study therefore aimed to investigate the prevalence of active MTrP’s in specific head and neck muscles/muscle groups in patients with CTTH.Methods: A prospective, cross-sectional and descriptive study was done in two primary health care facilities situated in Tshwane, South Africa. The sample included 97 adult patients with CTTH. Five head and neck muscles/muscle groups were examined bilaterally for active MTrPs. Outcome measures were the prevalence and distribution of active MTrPs in these patients.Results: Active MTrPs were found in 95.9% of the patients, the majority (74.2%) having four or more active MTrPs. The temporalis muscles and suboccipital muscle group exhibited the highest number of active MTrPs (prevalence 87.6% and 80.4% respectively).Conclusion: Our study suggests a strong association between MPS and CTTH in patients, presenting in the primary health care setting. This indicates the importance of a musculoskeletal assessment of neck and pericranial muscles in patients with CTTH. This can assist in determining the most appropriate treatment strategy in these patients.

Prevalence of myofascial trigger points in non-specific neck or shoulder pain among University students

Prevalence of myofascial trigger points in non-specific neck or shoulder pain among University students

Effect of exams period on prevalence of Myofascial Trigger points and head posture in undergraduate students: Repeated measurements study

Myofascial Trigger points (MTrPs) may be caused or aggravated by many factors, such as mental stress associated with exams and impaired posture. To compare the prevalence and sensitivity of MTrPs, and forward head position (FHP) during exam period vs. mid-semester among physical therapy students. 39 physical therapy students were palpated for MTrPs in neck and shoulder muscles and were photographed laterally for FHP measurement during the academic semester and during the academic examination period. The subjects showed higher prevalence of active MTrPs in the right Trapezius and Levator Scapula muscles, and higher prevalence of latent MTrPs in the left Sternocleidomastoideus and Levator Scapula muscles during exams, as well as a higher rate of tenderness in suboccipital musculature. Physical therapy students show greater prevalence of MTrPs during exams. The authors recommend implementing preventative programs towards the examination period.

Active myofascial trigger points in head and neck muscles of patients with chronic tension-type headache in two primary health care units in Tshwane

Background: The management of patients presenting with chronic tension-type headache (CTTH) can be challenging for primary health care practitioners. As with most chronic pain disorders, a multimodal management approach is frequently required. It has been postulated that myofascial pain syndrome (MPS) and its hallmark myofascial trigger points (MTrPs) found in specific muscle tissues may play a role in the chronic pain experienced by patients with CTTH. Little is known about the prevalence of MTrPs in patients with CTTH, in primary health care settings on the African continent. This study therefore aimed to investigate the prevalence of active MTrP’s in specific head and neck muscles/muscle groups in patients with CTTH.Methods: A prospective, cross-sectional and descriptive study was done in two primary health care facilities situated in Tshwane, South Africa. The sample included 97 adult patients with CTTH. Five head and neck muscles/muscle groups were examined bilaterally for active MTrPs. Outcome measu...

Prevalence, Incidence, Localization, and Pathophysiology of Myofascial Trigger Points in Patients With Spinal Pain: A Systematic Literature Review

ObjectiveA systematic review was performed to evaluate the existing evidence related to the prevalence, incidence, localization, and pathophysiology of myofascial trigger points (MTrPs) in patients with spinal (back and neck) pain. MethodsA systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed in 2 electronic databases (PubMed and Web of Science) using predefined keywords regarding MTrPs and spinal pain. A “PICOS” questionnaire was used to set up the search strategies and inclusion criteria. Full-text reports concerning MTrPs in patients with back or neck pain, which described their prevalence, incidence, location, or underlying physiopathology were included and screened for methodological quality by 3 independent researchers. Each study was assessed for risk of bias using a checklist derived from the Web site of the Dutch Cochrane Centre. ResultsFourteen articles were retrieved for quality assessment and data extraction. Studies reporting the incidence of MTrPs in patients with spinal pain were lacking. Within spinal pain, patients with neck pain were found to have the highest prevalence rates of MTrPs. The trapezius descendens, levator scapulae, and suboccipitales muscles were the most prevalent locations for active MTrPs in patients with neck pain. Latent MTrPs were present in asymptomatic people, but no significant differences were found in the prevalence rate of latent MTrPs between patients with spinal (neck) pain and healthy controls. The only study investigating prevalence of MTrPs in different localizations of the same muscle reported no significant differences in prevalence between active and latent MTrPs within the trapezius descendens muscle. Studies examining pathophysiological mechanisms underlying MTrPs demonstrated an acidic environment, high concentration of algogenic/inflammatory substances, stiffer muscle tissue, retrograde diastolic blood flows, spontaneous muscle activity at rest, and loss of muscle contractibility in muscles with MTrPs. Altered central processing was also found to play a role in the development of MTrPs. ConclusionsMyofascial trigger points are a prevalent clinical entity, especially in patients with neck pain. Evidence was not found to support or deny the role of MTrPs in other spinal pain. Compelling evidence supports local mechanisms underlying MTrPs. Future research should unravel the relevance of central mechanisms and investigate the incidence of MTrPs in patients with spinal pain.

The prevalence of myofascial trigger points in spinal disorders: a systematic review and meta-analysis

The prevalence of myofascial trigger points in spinal disorders: a systematic review and meta-analysis