Myofascial pain and treatment: Editorial a critical overview of the current myofascial pain literature – August 2019

Abstract

This quarter's overview of the myofascial pain literature includes quite a few basic research papers in addition to the usual high quantity of dry needling (DN) papers. Of particular interest are a study by Fischer and colleagues studying the role of mitochondrial functions in chronic trigger points (TrPs) (Fischer et al 2018), a study by Li and associates who conducted a quantitative proteomics analysis to identify biomarkers of chronic myofascial pain and therapeutic targets of dry needling in a rat model of TrPs (Li et al 2019), and a sonography study by Mitchell et al. looking into the distances from the skin to the pleura in the context of DN (Mitchell et al 2019). A total of 33 papers are included in this overview article.

Pressure Release Technique Versus Placebo Applied to Cervical and Masticatory Muscles in Patients With Chronic Painful Myofascial Temporomandibular Disorder. A Randomized Clinical Trial

“…These studies demonstrated good results in terms of pain reduction compared to both sham intervention and ultrasound, although it was similar to the effect of ischemic compression. It can be speculated that the key to the success in the present study was to apply PRT in two anatomical regions, the cervical and trigeminal region, since both masticatory and cervical muscles can refer pain to the orofacial and temporomandibular areas [11].…”

“…Nevertheless, the main reason for clinical consultation is chronic and persistent orofacial pain [10]. A common clinical nding is that TMD pain can originate in so-called trigger points (TrPs) of the masticatory and cervical muscles, which refer pain to the orofacial and temporomandibular regions [1,11]. TrPs are however enigmatic as the underlying pathophysiology remains unclear and the speci c differences between TrPs and points in the muscles that are simply tender or painful to palpation continue to be discussed [12,13].…”

Pressure release technique versus placebo applied to cervical and masticatory muscles in patients with chronic painful myofascial temporomandibular disorder: A randomised clinical trial

“…10 A common clinical finding is that TMD pain can originate in so-called trigger points (TrPs) of the masticatory and cervical muscles, which refer pain to the oro-facial and temporomandibular regions. 1,11 TrPs are however enigmatic as the underlying pathophysiology remains unclear and discussed. 12,13 The therapeutic approach to myofascial TMD should focus on pain relief and rehabilitation of function and to prevent or remove predisposing and/or perpetuating factors, by non-invasive, simple and reversible therapies that adhere to the biopsychosocial approach such as conservative dentistry, physiotherapy and psychology.…”

“…It can be speculated that the key to the success in the present study was to apply PRT in two anatomical regions, the cervical and trigeminal region, since both masticatory and cervical muscles can refer pain to the oro-facial and temporomandibular areas. 11 Secondary outcomes. In relation to secondary outcome measures it was observed that for all PPTs the effects only depended on time.…”

Review of Trigger Point Therapy for the Treatment of Myofascial Pain Syndromes

“…Another theory suggests that prolonged muscle contraction is an offending mechanism, resulting in local tissue ischemia and the accumulation of metabolic byproducts. These events perpetuate a cycle of motor and sympathetic activity that leads to a pain response, which can persist even after removal of the initial stimulus 19 . Given these proposed pathophysiology's of MPS, it is believed that mechanical disruption with a needle, with or without injectate, is necessary to terminate the nerve endplate dysfunction and allow for prolonged pain relief 6 .…”