From the Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts (JFA); the Department of Rehabilitation, Boston University Medical School, Boston, Massachusetts (FW); and the Department of Anesthesiology, Albany Medical College, Albany, New York (HS).
Presented as an abstract and scientific paper at the Association for Academic Physiatrists Meeting, February 2001.
Correspondence:
All correspondence and requests for reprints should be addressed to Joseph F. Audette, MD, Spaulding Rehabilitation Hospital, 125 Nashua Street, Boston, MA 02114.
Objectives: On completion of this article, the reader should be able to (1) identify the clinical and objective pathophysiologic differences between an active and latent myofascial trigger points (MTrPs) observed in this study population, (2) evaluate the electromyographic evidence presented that the perpetuation of active MTrPs involves the loss of central inhibition, similar to what is believed to occur in neuropathic pain conditions, and apply this consideration to make better clinical decisions in the treatment of individuals with chronic myofascial pain, (3) cite other chronic pain conditions in which “mirror image” or bilateral pathologic changes occur over time and consider that these syndromes may share a similar underlying pathophysiologic mechanism with chronic myofascial pain, especially in understanding the cause of the malignant spread of painful areas that occur over time in soft tissue pain conditions.
Level: Advanced.
Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians.
The Association of Academic Physiatrists designates this continuing medical education activity for a maximum of 1.5 credit hours in Category 1 of Physician's Recognition Award of the American Medical Association. Each physician should claim only those hours of credit that he or she actually spent in the education activity.
Disclosure: Disclosure statements have been obtained regarding the authors' relationships with financial supporters of this activity. There is no apparent conflict of interests related to the context of participation of the authors of this article.
How to Obtain CME Category 1 Credits
To obtain CME Category 1 credit, this educational activity must be completed and postmarked by December 31, 2005. Participants may read the article and take the exam issue by issue or wait to study several issues together. After reading the CME Article in this issue, participants may complete the Self-Assessment Exam by answering the questions on the CME Answering Sheet and the Evaluation pages, which appear later in this section. Send the completed forms to: Bradley R. Johns, Managing Editor, CME Department-AAP, American Journal of Physical Medicine & Rehabilitation, 7240 Fish-back Hill Lane, Indianapolis, IN 46278. Documentation can be received at the AAP National Office at any time throughout the year, and accurate records will be maintained for each participant. CME certificates are issued only once a year in January for the total number of credits earned during the prior year.
