II. Pathophysiology
- Contrast Trigger Points with Tender Points which were part of the original Fibromyalgia diagnostic criteria
- Trigger Points are central to Myofascial Pain Syndrome
- Trigger Points are associated with generalized Muscle changes
- Tense skeletal Muscle bands
- Muscle shortening
- Muscle Weakness
- Decreased Muscle range of motion
- Trigger Point compression induces local and referred pain
- Compression of Trigger Point leads to local ischemia
- Ischemia leads to local inflammatory factor (Prostaglandin, kinin) release
III. Preparation
- Patient examined in relaxed position
IV. Signs
- See Trigger Point Locations
- Taut, ropy bands, knots or Nodules of Muscle fibers
- Surrounded by normal feeling Muscle
-
Muscle tenderness to palpation
- Local twitch response to palpation ("jump sign")
- Involuntary shortening of fibrous Muscle band
- Trigger Points occur in predictable locations
- Pain Radiation
- Dull, aching, deep pain on Trigger Point palpation
- Predictable referred pain to distal reference zones
- Functional Disability
- Decreased range of motion
- Decreased flexibility on active and passive stretch
- Weakness of affected Muscle
- Trigger Point pain types
- Active Trigger Point
- Ongoing, persistent pain
- May activate satellite or secondary Trigger Points
- Latent Trigger Point
- Asymptomatic until palpated
- Active Trigger Point
V. Differential Diagnosis: Tender Point (Fibromyalgia)
- Specific, symmetrical localized points in Fibromyalgia
- Tender Points are associated with total body pain
- Tender Points not associated with referred pain
VI. Management
VII. Resources
- Trigger Point Physiology from Myopoint
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Finding (T033) |
| English | Myofascial Trigger Point, myofascial trigger point, myofascial trigger points |
Ontology: Trigger point (C0458343)
| Definition (MSHCZE) | Určitá místa v těle, jejichž stimulace vyvolá vjemy nebo příznaky jinde v těle. R |
| Definition (MSH) | Discrete spots in taut bands of muscle that produce local and referred pain when muscle bands are compressed. |
| Concepts | Body Location or Region (T029) |
| MSH | D061028 |
| SnomedCT | 183975007, 134190002 |
| English | points triggering, point trigger, points trigger, trigger point, Trigger Points, Point, Trigger, Trigger Point, Points, Trigger, TP - Trigger point, Trigger point (body structure), Trigger point |
| French | Points détente, Points de déclenchement, Points gâchette |
| Portuguese | Pontos-Gatilho, Pontos Gatilhos |
| Russian | ТРИГГЕРНЫЕ ТОЧКИ, TRIGGERNYE TOCHKI, TRIGGERNYE OBLASTI, ТРИГГЕРНЫЕ ОБЛАСТИ |
| Spanish | Puntos Disparadores, Puntos Desencadenantes, Puntos Gatillo, Puntos Gatillos, zona gatillo (estructura corporal), zona gatillo |
| Czech | spouštěcí body, spoušťový bod |
| Polish | Punkty spustowe |
| Italian | Punti trigger |
| German | Triggerpunkt, Triggerpunkte |
| Norwegian | Triggerpunkter, Triggerpunkt |
