Fibromyalgia Syndrome Are Frequently Associated With Myofascial Trigger P=
oints.
J Pain. 2009 Nov 13. [Epub ahead of print]
Ge HY, Wang Y, Danneskiold-Sams=F8e B, Graven-Nielsen T, Arendt-Nielsen L.
Laboratory for Musculoskeletal Pain and Motor Control, Center for=20
Sensory-Motor Interaction (SMI), Department of Health Science and=20
Technology, Aalborg University, Aalborg, DK-9220, Denmark.
PMID: 19914876
The aim of this present study is to test the hypotheses that the 18=20
predetermined sites of examination for tender points (TP sites) in=20
fibromyalgia syndrome (FMS) are myofascial trigger points (MTrPs),=20
and that the induced pain from active MTrPs at TP sites may mimic=20
fibromyalgia pain.
Each TP site was evaluated with manual palpation followed by=20
intramuscular electromyographic (EMG) registration of spontaneous=20
electrical activity to confirm or refute the existence of an MTrP in=20
30 FMS patients. Overall spontaneous pain intensity and pain pattern=20
were recorded before manual identification of MTrPs. Local and=20
referred pain pattern from active MTrPs were drawn following manual=20
palpation at TP sites.
RESULTS: showed that most of the TP sites are MTrPs. Local and=20
referred pain from active MTrPs reproduced partly the overall=20
spontaneous pain pattern. The total number of active MTrPs (r =3D .78,=20
P < .0001), but not latent MTrPs (r =3D -.001, P =3D .99), was positively=
=20
correlated with spontaneous pain intensity in FMS. The current study=20
provides first evidence that pain from active MTrPs at TP sites=20
mimics fibromyalgia pain. MTrPs may relate to generalized increased=20
sensitivity in FMS due to central sensitization.
PERSPECTIVE: This article underlies the importance of active MTrPs in=20
FMS patients. Most of the TP sites in FMS are MTrPs. Active MTrPs may=20
serve as a peripheral generator of fibromyalgia pain and inactivation=20
of active MTrPs may thus be an alternative for the treatment of FMS.
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