Myofascial pain

Similar to FMS, MFP has many different labels. It has been cited under different headings over the years including fibrositis and myofibrositis when distinction between FMS was not so clear. MFP was first defined in the 1950s as was the "trigger point'' which characterizes the condition.16 More research into its pathophysiology has led to clearer definition between MFP and FMS. However, research into this condition has been hampered by the lack of classification/diagnostic criteria. Heterogeneity in patient populations across studies is always a potential confounder which may explain different observations. This problem has been addressed by the publication of Long and Kephort's modified criteria (Box 42.1) in 1998 which are now commonly used.17

The trigger point feels harder than the surrounding muscle, as within the trigger point the muscle has formed a tense "knot." Palpation of a trigger point causes local and referred pain, the latter of which is not a feature of FMS tender points. This trigger point can also be associated with a twitch response which is termed the "jump sign.'' It can be active or latent, a latent trigger point will not be associated with referred or spontaneous pain, but is still sensitive to palpation.

MFP can be labeled under different terms depending on the area of the body that it affects such as tempor-omandibular disorder (TMD), low back pain, and tension headache. It is also associated with limited movement, weakness, and autonomic dysfunction.

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