Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Chronic myofascial pain (CMP) ++ 729.1 Myalgia and myositis unspecified ++ M60.9 Myositis, unspecifiedM79.1 Myalgia ++ 4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Connective Tissue Dysfunction +++ Description ++ Chronic, persistent, deep aching pains in muscle; non-articular in originCharacterized by well-defined, highly sensitive tender spots (trigger points)Usually caused by sudden overload, overstretching and/or repetitive/sustained muscle activitiesPain associated with activities, and generally relieved with restFascial restrictionsCan be in localized areas affecting any muscle or fascia +++ Essentials of Diagnosis ++ 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 tender pointsAccording 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. ++ Minor criteria include: ++ 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 trigger point. +++ General Considerations ++ Very common; affects most people during their lifetimeTrigger points: active trigger points are tender to palpation and have a characteristic referral pattern of pain when provokedLatent trigger points are palpable taut bands that are not tender to palpation, but can be converted into an active trigger point +++ Demographics ++ In the US, 14.4% of the general population suffers from chronic musculoskeletal pain221-93% of patients with regional pain complaints have myofascial pain125-54% of asymptomatic individuals have latent trigger points3No racial differences in the incidence of myofascial pain have been described in the literatureMyofascial pain is distributed equally between men and womenMyofascial trigger points can be found in persons/children of all agesThe likelihood of developing active trigger points increases with age and activity levelSedentary individuals are more prone to develop active trigger points than are individuals who exercise vigorously on a daily basis +++ Signs and Symptoms ++ Muscle stiffnessHeadachesVertigoParesthesiasReferred painJoint stiffnessLimited range of motionDeep aching pain that is constantPain upon palpation of ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.