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Trigger Point
Aka: Trigger Point
- See Also
- Myofascial Pain Syndrome
- Trigger Point Locations
- Trigger Point Injection
- Pathophysiology
- Trigger Points are central to Myofascial Pain Syndrome
- Trigger Points result in 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
- Preparation for exam
- Patient examined in relaxed position
- 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
- Trigger Points occur longitudinally along Muscle axis
- Trigger Points are consistent from patient to patient
- Axial Muscles (Posture) most commonly affected
- 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
- 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
- Management
- See Myofascial Pain Syndrome
- See Trigger Point Injection
- See Stretch and Spray
- See Chronic Pain Management
- Resources
- Trigger Point Physiology from Myopoint
- http://myopoint.com/network/physicians/myalgia.htm
- References
- Alvarez (2002) Am Fam Physician 65(4): 653-60 [PubMed]
- Fomby (1997) Phys Sportsmed 25(2):67-75 [PubMed]