Article: [Differences between myofascial trigger points and tender points]

The article describes and compares the characteristics of myofascial trigger points (MTrPs) of the myofascial pain syndrome and the tender points (TePs) of the fibromyalgia syndrome. Many statements are hypothetical, because not all aspects of the disorders have been clarified in solid studies. Signs and symptoms of MTrPs: (1) palpable nodule, often located close to the muscle belly, (2) often single, (3) allodynia and hyperalgesia at the MTrP, (4) referral of the MTrP pain, (5) normal pain sensitivity outside the MTrPs, (6) local twitch response, (7) local contracture in biopsy material, (8) peripheral mechanism probable. Signs and symptoms of TePs: (1) no palpable nodule, (2) location often close to the muscle attachments, (3) multiple by definition, (4) allodynia and hyperalgesia also outside the TePs, (5) enhanced pain under psychic stress, (6) unspecific histological changes in biopsy material, (7) central nervous mechanism probable. The multitude of differences speak against a common aetiology and pathophysiology.

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References

1.

Shah J, Phillips T, Danoff J, Gerber L . An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol (1985). 2005; 99(5):1977-84. DOI: 10.1152/japplphysiol.00419.2005. View

2.

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

3.

Harris R, Clauw D, Scott D, McLean S, Gracely R, Zubieta J . Decreased central mu-opioid receptor availability in fibromyalgia. J Neurosci. 2007; 27(37):10000-6. PMC: 6672650. DOI: 10.1523/JNEUROSCI.2849-07.2007. View

4.

Chen Q, Basford J, An K . Ability of magnetic resonance elastography to assess taut bands. Clin Biomech (Bristol). 2008; 23(5):623-9. PMC: 2474796. DOI: 10.1016/j.clinbiomech.2007.12.002. View

5.

Morf S, Amann-Vesti B, Forster A, Franzeck U, Koppensteiner R, Uebelhart D . Microcirculation abnormalities in patients with fibromyalgia - measured by capillary microscopy and laser fluxmetry. Arthritis Res Ther. 2005; 7(2):R209-16. PMC: 1065312. DOI: 10.1186/ar1459. View

6.

Yu X, Mense S . Response properties and descending control of rat dorsal horn neurons with deep receptive fields. Neuroscience. 1990; 39(3):823-31. DOI: 10.1016/0306-4522(90)90265-6. View

7.

Hoheisel U, Reinohl J, Unger T, Mense S . Acidic pH and capsaicin activate mechanosensitive group IV muscle receptors in the rat. Pain. 2004; 110(1-2):149-57. DOI: 10.1016/j.pain.2004.03.043. View

8.

Katz R, Wolfe F, Michaud K . Fibromyalgia diagnosis: a comparison of clinical, survey, and American College of Rheumatology criteria. Arthritis Rheum. 2005; 54(1):169-76. DOI: 10.1002/art.21533. View

9.

Bruckle W, Suckfull M, Fleckenstein W, Weiss C, Muller W . [Tissue pO2 measurement in taut back musculature (m. erector spinae)]. Z Rheumatol. 1990; 49(4):208-16. View

10.

Hubbard D, Berkoff G . Myofascial trigger points show spontaneous needle EMG activity. Spine (Phila Pa 1976). 1993; 18(13):1803-7. DOI: 10.1097/00007632-199310000-00015. View

11.

Cook D, Lange G, Ciccone D, Liu W, Steffener J, Natelson B . Functional imaging of pain in patients with primary fibromyalgia. J Rheumatol. 2004; 31(2):364-78. View

12.

Simons D, Stolov W . Microscopic features and transient contraction of palpable bands in canine muscle. Am J Phys Med. 1976; 55(2):65-88. View

[Differences Between Myofascial Trigger Points and Tender Points]