Abstract
Simons DG. New views of myofascial trigger points: etiology and diagnosis.
Two studies appearing in Archives, one by Shah and colleagues and another one by Chen and colleagues, present groundbreaking
findings that can reduce some of the controversy surrounding myofascial trigger points
(MTPs). Both author groups recognize the ubiquity of this disease and the importance
to patients of health care professionals becoming better acquainted with the cause
and identification of MTPs. The integrated hypothesis is the most credible and most
complete proposed etiology of MTPs. However, the feedback loop suggested in this hypothesis
has a few weak links, and studies by Shah and colleagues in particular supply a solid
link for one of them. The feedback loop connects the hypothesized energy crisis with
the milieu changes responsible for noxious stimulation of local nociceptors that causes
the local and referred pain of MTPs. Shah’s reports quantify the presence of not just
1 noxious stimulant but 11 of them with outstanding concentrations of immune system
histochemicals. The results also strongly place a solid histochemical base under the
important clinical distinction between active and latent MTPs. The study by Chen on
the use of magnetic resonance elastography (MRE) imaging of the taut band of an MTP
in an upper trapezius muscle may open a whole new chapter in the centuries-old search
for a convincing demonstration of the cause of MTP symptoms. MRE is a modification
of existing magnetic resonance imaging equipment, and it images stress produced by
adjacent tissues with different degrees of tension. This report seems to present an
MRE image of the taut band that shows the chevron signature of the increased tension
of the taut band compared with surrounding tissues.
Key Words
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Article info
Footnotes
See original articles, p 1658 (2007), p 16 (2008).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
Reprints are not available from the author.
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Copyright
© 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
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- Identification and Quantification of Myofascial Taut Bands With Magnetic Resonance ElastographyArchives of Physical Medicine and RehabilitationVol. 88Issue 12
- Biochemicals Associated With Pain and Inflammation are Elevated in Sites Near to and Remote From Active Myofascial Trigger PointsArchives of Physical Medicine and RehabilitationVol. 89Issue 1
