From the Guidelines
A myofascial trigger point is a specific area of muscle tissue that is sensitive to pressure and can cause pain and stiffness.
Characteristics of Myofascial Trigger Points
- They are areas of hyperirritable muscle tissue that can cause pain, stiffness, and limited range of motion 1
- They can be found in various parts of the body, including the neck, back, and jaw 1
- They can be treated with various therapies, including manual trigger point therapy, dry needling, and ischemic compression 1
Diagnosis and Treatment
- Diagnosis is typically based on clinical examination, including palpation and assessment of pain and stiffness 1
- Treatment options include cognitive behavioral therapy, manual trigger point therapy, and pharmacological therapies such as NSAIDs and biologic DMARDs 1
- It is essential to distinguish between myofascial trigger points and other conditions, such as enthesitis and widespread pain syndromes 1
From the Research
Definition of Myofascial Trigger Point
A myofascial trigger point (MTrP) is defined as a hard, discrete, palpable nodule in a taut band of skeletal muscle that may be spontaneously painful (i.e., active) or painful only on compression (i.e., latent) 2. It is a hyperirritable spot, usually within a taut band of skeletal muscle, which is painful on compression and can give rise to characteristic referred pain, motor dysfunction, and autonomic phenomena 3, 4.
Characteristics of Myofascial Trigger Points
The key characteristics of MTrPs include:
- Hard, discrete, palpable nodules in a taut band of skeletal muscle 2
- Hyperirritable points located within a taut band of skeletal muscle or fascia 5
- Painful on compression, with referred pain, local tenderness, and autonomic changes 5, 3, 4
- Can be active (spontaneously painful) or latent (painful only on compression) 2, 5
Relationship to Myofascial Pain Syndrome
MTrPs are central to myofascial pain syndrome (MPS), a pain condition that can be acute or chronic and involves the muscle and its surrounding connective tissue (e.g., fascia) 2. The soft tissue milieu around the MTrP, neurogenic inflammation, sensitization, and limbic system dysfunction may all play a role in the initiation, amplification, and perpetuation of MPS 2.
Anatomy and Distribution
Recent studies suggest that nerve entry points (NEPs) may be the anatomical basis for MTrPs, providing a novel and practical foundation for identifying and treating pain conditions associated with MTrPs 6. The distribution of NEPs may help explain the spatial distribution of MTrPs, which has been a topic of ongoing research and debate 6.