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Myofascial pain syndrome and trigger points

evaluation and treatment in patients with musculoskeletal pain

Barbero, Marcoa,b; Schneebeli, Alessandroa; Koetsier, Evab,c; Maino, Paolob,c

Current Opinion in Supportive and Palliative Care: September 2019 - Volume 13 - Issue 3 - p 270–276
doi: 10.1097/SPC.0000000000000445
MUSCULOSKELETAL PROBLEMS: Edited by Roberto Casale and Piercarlo Sarzi
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Purpose of review Myofascial pain syndrome is a chronic pain condition characterized by the presence of myofascial trigger point, a hyperirritable painful spot involving a limited number of muscle fibers. The literature suggest that myofascial trigger points should be considered peripheral pain generators and this critical review will summarize recent findings concerning the clinical evaluation and the treatment of myofascial trigger points.

Recent findings The clinical features of myofascial trigger points and their contribution to the patient pain and disability have been detailed in several recent studies, which support the clinical relevance of the condition. Recent studies reported that manual palpation to identify MTrPs has good reliability, although some limitations are intrinsic to the diagnostic criteria. During the last decade, a plethora of treatments have been proposed and positive effects on pain and function demonstrated.

Summary The myofascial trigger point phenomenon has good face validity and is clinically relevant. Clinicians are encouraged to consider the contribution of myofascial trigger points to the patient's pain and disability through a careful medical history and a specific manual examination. Patients with myofascial trigger points will benefit from a multimodal treatment plan including dry needling and manual therapy techniques. Internal and external validity of research within the field must be improved.

aRehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Manno

bPain Management Center, Neurocenter of Southern Switzerland

cDivision of Anaesthesiology, Department of Acute Medicine, Regional Hospital of Lugano, Lugano, Switzerland

Correspondence to Prof. Marco Barbero, PT PhD – Head of Laboratory, Head of Laboratory of Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Stabile Piazzetta, Via Violino 11, CH-6928 Manno, Switzerland. Tel: +41 (0)58 666 64 35; e-mail: marco.barbero@supsi.ch;website:http://www.supsi.ch/rrlab

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