Critical Evaluation about Diagnosis and Treatment of Myofascial Trigger Points

Abstract

PURPOSE The purpose of this study was to analyze the flaws in the evidence that supports myofascial trigger points and whether various myofascial trigger point treatment is applicable for clinical use. METHODS The databases of MEDLINE, CINAHL, Korea University library, and Google Scholar were searched with no limitation period. Key terms including “myofascia”, “trigger points”, “myofascial trigger points”, “myofascial pain syndrome”, “neuroinflammation”, “neuritis”, “fibrotic nodules”, “muscle pain”, and “referral pain” were used to find eligible studies. The eligible studies were screened by 7 independent reviewers who rated reliability and validity of myofascial trigger points. Forty-seven studies were included. RESULTS Present results suggest that diagnostic reliability of myofascial trigger points seems to be limited. All things considered, there is no reliable clinical evidence regarding the diagnosis and treatment for myofascial trigger points. A myofascial trigger point theory may be replaced by a neuritis model where the model can clarify the mechanisms of muscle pain that are thought to be a cause of myofascial trigger points. CONCLUSIONS This study contends the reliability of myofascial trigger points as an explanation for muscle pain. However, future neuritis-related studies on noxious sensitization and muscle pain could establish thoughtful insights on muscle pain.

Keywords

• myofascia
• muscle pain
• myofascial trigger points
• myofascial pain syndrome
• neuritis