Fibromyalgia, myofascial pain, tender points and trigger points splitting or lumping.docVIP

Bennett and Goldenberg Arthritis Research Therapy 2011,13:117 /content/13/3/117 EDITO RIAL Fibromyalgia, myofascial pain, tender points and trigger points: splitting or lumping? Robert M Bennett* and Don L Goldenberg 1 2 See related research by Ge et al., /content/13/2/R48 mirrored onto the 30 healthy controls as an aid to identifying latent MTPs; sponta neous electrical activity Abstract Myofascial trigger points (MTPs) have long been a contentious issue in relation to ?bromyalgia, and poorly de?ned pain complaints in general. Can MTPs be reproducibly identi?ed? Do MTPs have valid objective ?ndings, such as spontaneous electromyographic activity, muscle microdialysis evidence for an in?ammatory milieu or visualization with newer ultrasound techniques? Is ?bromyalgia a syndrome of multiple MTPs, or is focal muscle tenderness a manifestation of central sensitization? These issues are discussed with relevance to a recent paper reporting that manual palpation of active MTPs elicits the spontaneous pain experienced by ?bromyalgia patients. was found in 304 of these latent MTPs. e major MTP in each muscle was manually palpated at a pressure of about 4 kg for 10 seconds, and the location and area of referred pain was drawn by the subject and later digitized for subsequent analysis. e major ? ndings were as follows. e intensity of the spontaneous pain in FM was strongly correlated with the total area of pain referred by manual palpation of MTPs. Manual stimulation of active MTPs in FM produces a local and referred pain pattern that is similar to the subject’s current spontaneous pain report e locations of active MTPs in FM subjects were generally found to be the site of latent MTPs in the controls e overall number of MTPs was similar in both the FM patients and control subjects, but FM subjects had active MTPs whe