Regional myofascial pain: diagnosis and management

Imperforate Hymen Presenting as Chronic Low Back Pain

“…There are, however, a number of precipitating factors that could enhance a child' s susceptibility to the evolution of trigger points, namely, trauma, neurologic disease, anxiety disorder, and visceral pathology causing a viscerosomatic reflex. 11 In visceral disorders, afferent fibers from the organ send signals to the spinal cord. This induces central sensitization with secondary hypersensitivity and expansion in the number and size of receptive fields.…”

A Brief Overview of Myofascial Trigger Points.

“…Therefore, a high level of manual skill is required to detect these points accurately. There are four major clinical features of MTrPs as follows (Cummings and Baldry, 2007):  A tender point in the taut muscle tissue  A possible pattern of pain distribution  Patient/client recognition of pain dueing continued pressure over MTrPs  A local twitch response (LTR), which is a temporary and a quick contraction of the muscle fibre during pincer palpation of MTrPs. LTR could be visible or palpable, or both.…”

“…These points are painful and may produce referred pain, either spontaneously or due to direct pressure. MTrPs can be regarded as one of the most frequent causes of pain and disability in the muscular and skeletal system (Cummings and Baldry, 2007). It is desirable to clarify theories and explanations regarding the MTrP mechanism and its relation to pain?…”

Diagnostic Perils in Jaw Pain

“…• Treatment includes maintaining proper body posture, physical therapy (transcutaneous nerve stimulation (TENS), cryotherapy), spray and stretch, local anesthetic injection of the involved muscle and even low level laser. 6 • NSAIDs continue to be popular among patients and in a recent study by Wolfe et al, NSAIDs were considered more effective than acetaminophen. 7 Other commonly used drugs include tramadol, tricyclic antidepressants such as amitriptyline, alpha-2 adrenergic agonists like clonidine and tizanidine.…”