Prevalence of Myofascial Trigger Points in Fibromyalgia: the Overlap of Two Common Problems

Overview

Journal Curr Pain Headache Rep

Date 2010 Jul 8

PMID 20607459

Citations 12

Authors

Hong-You Ge

Affiliations

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Abstract

With the objective evidence of their existence, myofascial trigger points (MTrPs) contribute to an increasing number of chronic regional and widespread pain conditions. The widespread spontaneous pain pattern in fibromyalgia (FM) is a summation of multiple regional pains due to active MTrPs. A regional pain in FM is from local active MTrPs and/or referred from remote active MTrPs. Positive tender points specified in FM are MTrPs, either active or latent. Manual stimulation of active MTrPs located in the muscles in different body regions completely reproduced overall spontaneous FM pain pattern. Active MTrPs as tonic peripheral nociceptive input contribute tremendously to the initiation and maintenance of central sensitization, to the impairment of descending inhibition, to the increased excitability of motor units, and to the induction of sympathetic hyperactivity observed in FM. The considerable overlap of MTrPs and FM in pain characteristics and pathophysiology suggests that FM pain is largely due to MTrPs.

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References

Srbely J, Dickey J, Lowerison M, Edwards M, Nolet P, Wong L . Stimulation of myofascial trigger points with ultrasound induces segmental antinociceptive effects: a randomized controlled study. Pain. 2008; 139(2):260-266. DOI: 10.1016/j.pain.2008.04.009. View

Giamberardino M, Tafuri E, Savini A, Fabrizio A, Affaitati G, Lerza R . Contribution of myofascial trigger points to migraine symptoms. J Pain. 2007; 8(11):869-78. DOI: 10.1016/j.jpain.2007.06.002. View

Fernandez-Carnero J, Ge H, Kimura Y, Fernandez-de-Las-Penas C, Arendt-Nielsen L . Increased spontaneous electrical activity at a latent myofascial trigger point after nociceptive stimulation of another latent trigger point. Clin J Pain. 2010; 26(2):138-43. DOI: 10.1097/AJP.0b013e3181bad736. View

Chou L, Hsieh Y, Kao M, Hong C . Remote influences of acupuncture on the pain intensity and the amplitude changes of endplate noise in the myofascial trigger point of the upper trapezius muscle. Arch Phys Med Rehabil. 2009; 90(6):905-12. DOI: 10.1016/j.apmr.2008.12.020. View

Ge H, Wang Y, Danneskiold-Samsoe B, Graven-Nielsen T, Arendt-Nielsen L . The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points. J Pain. 2009; 11(7):644-51. DOI: 10.1016/j.jpain.2009.10.006. View

Fernandez-de-Las-Penas C, Simons D, Cuadrado M, Pareja J . The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck. Curr Pain Headache Rep. 2007; 11(5):365-72. DOI: 10.1007/s11916-007-0219-z. View

Macfarlane G . Generalized pain, fibromyalgia and regional pain: an epidemiological view. Baillieres Best Pract Res Clin Rheumatol. 1999; 13(3):403-14. DOI: 10.1053/berh.1999.0029. View

Niddam D, Chan R, Lee S, Yeh T, Hsieh J . Central modulation of pain evoked from myofascial trigger point. Clin J Pain. 2007; 23(5):440-8. DOI: 10.1097/AJP.0b013e318058accb. View

Bengtsson A, Henriksson K, Jorfeldt L, Kagedal B, Lennmarken C, Lindstrom F . Primary fibromyalgia. A clinical and laboratory study of 55 patients. Scand J Rheumatol. 1986; 15(3):340-7. DOI: 10.3109/03009748609092601. View

10.

Shah J, Danoff J, Desai M, Parikh S, Nakamura L, Phillips T . Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil. 2008; 89(1):16-23. DOI: 10.1016/j.apmr.2007.10.018. View

11.

Furuta S, Shimizu T, Matsumoto K, Kuzumaki N, Horie S, Suzuki T . Subdiaphragmatic vagotomy promotes nociceptive sensitivity of deep tissue in rats. Neuroscience. 2009; 164(3):1252-62. DOI: 10.1016/j.neuroscience.2009.09.021. View

12.

Light A, White A, Hughen R, Light K . Moderate exercise increases expression for sensory, adrenergic, and immune genes in chronic fatigue syndrome patients but not in normal subjects. J Pain. 2009; 10(10):1099-112. PMC: 2757484. DOI: 10.1016/j.jpain.2009.06.003. View

13.

Anderson R, Sawyer T, Wise D, Morey A, Nathanson B . Painful myofascial trigger points and pain sites in men with chronic prostatitis/chronic pelvic pain syndrome. J Urol. 2009; 182(6):2753-8. DOI: 10.1016/j.juro.2009.08.033. View

14.

Harris R, Sundgren P, Craig A, Kirshenbaum E, Sen A, Napadow V . Elevated insular glutamate in fibromyalgia is associated with experimental pain. Arthritis Rheum. 2009; 60(10):3146-52. PMC: 2827610. DOI: 10.1002/art.24849. View

15.

Giske L, Vollestad N, Mengshoel A, Jensen J, Knardahl S, Roe C . Attenuated adrenergic responses to exercise in women with fibromyalgia--a controlled study. Eur J Pain. 2007; 12(3):351-60. DOI: 10.1016/j.ejpain.2007.07.007. View

16.

Jensen K, Kosek E, Petzke F, Carville S, Fransson P, Marcus H . Evidence of dysfunctional pain inhibition in Fibromyalgia reflected in rACC during provoked pain. Pain. 2009; 144(1-2):95-100. DOI: 10.1016/j.pain.2009.03.018. View

17.

Kosek E, Ordeberg G . Lack of pressure pain modulation by heterotopic noxious conditioning stimulation in patients with painful osteoarthritis before, but not following, surgical pain relief. Pain. 2000; 88(1):69-78. DOI: 10.1016/S0304-3959(00)00310-9. View

18.

Ge H, Fernandez-de-Las-Penas C, Arendt-Nielsen L . Sympathetic facilitation of hyperalgesia evoked from myofascial tender and trigger points in patients with unilateral shoulder pain. Clin Neurophysiol. 2006; 117(7):1545-50. DOI: 10.1016/j.clinph.2006.03.026. View

19.

Wolfe F, Simons D, Fricton J, Bennett R, Goldenberg D, Gerwin R . The fibromyalgia and myofascial pain syndromes: a preliminary study of tender points and trigger points in persons with fibromyalgia, myofascial pain syndrome and no disease. J Rheumatol. 1992; 19(6):944-51. View

20.

Wolfe F, Smythe H, Yunus M, Bennett R, Bombardier C, Goldenberg D . The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990; 33(2):160-72. DOI: 10.1002/art.1780330203. View