- Chronic myofascial pain (CMP)
- 729.1 Myalgia and myositis unspecified
- M60.9 Myositis, unspecified
- M79.1 Myalgia
- Chronic, persistent, deep aching pains in muscle; non-articular
- Characterized by well-defined, highly sensitive tender spots
- Usually caused by sudden overload, overstretching and/or
repetitive/sustained muscle activities
- Pain associated with activities, and generally relieved with
- Fascial restrictions
- Can be in localized areas affecting any muscle or fascia
- Presence of myofascial trigger points (MTrPs).
- Diagnosis is made by clinical assessment (generally palpation)
with no diagnostic tests available.
- Differentiates from fibromyalgia as it can occur in a single
area, whereas fibromyalgia occurs in multiple locations and has
- According to Simons2 the diagnosis of MPS can be
made if five major criteria and at least one out of three minor
criteria are met.
- The major criteria are
- 1. Localized spontaneous pain.
- 2. Spontaneous pain or altered sensations in the expected
referred pain area for a given trigger point.
- 3. Presence of a taut palpable band in an accessible muscle.
- 4. Exquisite localized tenderness in a precise point along
the taut band.
- 5. Some degree of reduced range of movement when measurable.
- 1. Reproduction of spontaneously perceived pain and altered
sensations by pressure on the trigger point.
- 2. Elicitation of a local twitch response of muscular fibers
by "transverse" snapping palpation, or by needle insertion into
the trigger point.
- 3. Pain relieved by muscle stretching or injection of the
- Very common; affects most people during their lifetime
- Trigger points: active trigger points are tender to palpation
and have a characteristic referral pattern of pain when provoked
- Latent trigger points are palpable taut bands that are not
tender to palpation, but can be converted into an active trigger
- In the US, 14.4% of the general population suffers
from chronic musculoskeletal pain2
- 21-93% of patients with regional pain complaints
have myofascial pain1
- 25-54% of asymptomatic individuals have latent trigger
- No racial differences in the incidence of myofascial pain
have been described in the literature
- Myofascial pain is distributed equally between men and women
- Myofascial trigger points can be found in persons/children
of all ages
- The likelihood of developing active trigger points increases
with age and activity level
- Sedentary individuals are more prone to develop active trigger
points than are individuals who exercise vigorously on a daily basis
- Muscle stiffness
- Referred pain
- Joint stiffness
- Limited range of motion
- Deep aching pain that is constant
- Pain upon palpation of the trigger point
- Upon palpation ...
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