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Rehabilitation Practice and Science

Translated Title

肌筋膜引痛點的基本單元

Abstract

This report summarized recent studies on the basic structures of a myofascial trigger point (MTrP). A MTrP is a hyperirritable spot in a palpable taut band of skeletal muscle fibers. Spot tenderness, recognized pain, and taut band are now demonstrated to be reliable diagnostic criteria of an MTrP. Referred pain (ReP) or local twitch response (LTR) is a confirmatory sign of MTrP. There are multiple loci in an MTrP region. The basic unit of an MTrP is the MTrP locus which contains a sensory component (the sensitive locus) and a motor component (the active locus). A sensitive locus is the site from where a local pain, an ReP, or an LTR can be elicited by needle stimulation to that site. The sensitive loci are probably sensitized nerve fibers (nociceptors). They are widely distributed in the whole muscle, but concentrated in the MTrP region. Recent electrophysiological studies on both human and rabbit skeletal muscles suggested that both ReP and LTR are related to the spinal cord mechanism. An active locus is the site from where spontaneous electrical activity (SEA) can be recorded. SEA is abnormal endplate potentials due to excessive release of acetylcholine, which may cause the formation of a taut band. Recent histological studies have demonstrated a nerve fiber at the vicinity of a sensitive locus or an active locus in rabbit skeletal muscle. The pathogenesis of MTrPs is probably related to integrative mechanisms in the spinal cord in response to sensitized nerve fibers associated with abnormal endplates.

Language

English

First Page

161

Last Page

168

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