The Myofascial Pain Syndrome (MPS)l

7/28/2019 The Myofascial Pain Syndrome (MPS)l

http://slidepdf.com/reader/full/the-myofascial-pain-syndrome-mpsl 1/19

The myofascial pain syndrome (MPS)



Features of MTrPs Motor:

disturbed motor function

muscle weakness as a result of motorinhibition

muscle stiffness

restricted range of motion



Autonomic:

vasoconstriction

vasodilatation

Features of MTrPs



Features of MTrPs Sensory:

local tenderness referral of pain to a distant site

peripheral sensitization

central sensitization



Definition and type of Terms

Check handout please



Examples of the two directions in

which trigger point may referred

A .)Peripheral projection of pain from suboccipital and

infraspinatus trigger points( . B .)Mostly central projection of pain from biceps brachii

trigger points with some pain in the region of thedistal tendinous attachment of the muscle .



Other Muscle Pain

Terminology Fibrositis (Gowers,

1904)

Fibromyositis

(Telling, 1911) Myofasciitis (Albee,

1927)

Myofibrositis(Murray, 1929)

Perineuritis (Clayton& Livingstone, 1930)

Idiopathic myalgia (Gutstein-

Good, 1940)

Rheumatic myalgia (Good,

1941)

Myofascial Pain Syndrome

(Travell, 1948)

Myodysneuria (Gutstein,

1955)

Fibromyalgia (Yunus, 1977)



Prevalence

Research has shown that MTrPs are commonly associated with facet

joint dysfunctions, disc herniation, osteoarthritis, migraine, tensiontype headache, (Fybromyalgia), visceral disorders etc.Dommerholt, J. and T. Issa, Differential diagnosis: myofascial pain, in Fibromyalgia syndrome; a practitioner's guide to

treatment, L. Chaitow, Editor. 2003, Churchill Livingstone: Edinburgh. p. 149-177.

A survey of APS (American Pain Society)-members shows that88.5% consider MPS as a legitimate diagnosisHarden, R.N., et al., Signs and symptoms of the myofascial pain syndrome: a national survey of pain management providers. Clin J Pain, 2000. 16(1): p. 64-72.

80% of 1096 subjects involved in low-velocity activity developedactive trigger points (MTrP)Schuller, E., W. Eisenmenger, and G. Beier, Whiplash injury in low speed car accidents. J Musculoskeletal Pain, 2000.8(1/2): p. 55-67.



MTrPs have been identified with:

Radiculopathies joint dysfunction disk pathology tendonitis

Craniomandibular dysfunction migraines tension-type headaches carpal tunnel syndrome computer-related disorders whiplash associated disorders spinal dysfunction

pelvic pain and other urologicsyndromes

most pain syndromes

nocturnal cramps

phantom pain etc.



Etiology of MTrPs

Acute Overuse

Direct Trauma

Persistent Muscular Contraction(emotional or physical cause), i.e,:poor posture, repetitive motions, stress

response

Prolonged Immobility

Systemic Biochemical Imbalance



Diagnostic Criteria

taut band: the group of tense muscle fibersextending from a trigger

point to the muscleattachments, the tensionbeing caused bycontraction knots that are

located in the trigger pointregion



Diagnostic Criteria

spot tenderness within the taut band (nociceptiveinput into the dorsal horn contributing to wind-up

and central sensitization)

local twitch response.

referred pain.

Jump sign.



Identification

Myofascial Trigger Points

are identified by

physical examination,

specifically by palpation

There are two palpation

techniques:

Flat palpation

Pincer palpation

dependent upon the muscle



Manual Trigger Point Therapy

Trigger Point Techniques

Trigger Point Compression (Technique I)

Manual stretching of the taut band in muscle fibre direction (Technique II)

Release Techniques:

Myofascial Release (Technique III)

Intermuscular mobilisation (Technique IV)

Stretching Techniques:

Therapeutic stretching (Technique V)

Self stretching (Technique VI)




Trigger Point Compression (Technique I)




Manual stretching of the taut band

in muscle fiber direction

(Technique II)




Myofascial Release

(Technique III)




Intermuscular mobilisation

(Technique IV)



Thanks

The Myofascial Pain Syndrome (MPS)l

Documents

Transcript of The Myofascial Pain Syndrome (MPS)l