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Rehabilitation Practice and Science

Translated Title

肌筋膜激痛點的診斷

Abstract

In this review article, we have described the clinical approach in detecting and confirming myofascial trigger points (MTrPs) that elicit clinical complaints. In the last decade, the pathophysiology of MTrPs has been much clarified based on clinical and basic science research work. An MTrP is a hyperirritable spot in a taut band of skeletal muscle fibers with characteristics related to central sensitization in the spinal cord. The pathological diagnosis should include: (1) the electromyographic (EMG) recording and ultrasound imaging of local twitch responses (LTRs), (2) the EMG recording of spontaneous electrical activity (endplate noise) at multiple active loci in the MTrP, and (3) the biopsies of MTrP that show contraction knots and giant round muscle fibers. In clinical practice, the minimal diagnostic criteria should be: (1) hyperirritable tender spot, (2) pain recognition on this spot, (3) taut band containing this spot. Referred pain and local twitch response are confirmatory signs of MTrPs. In order to permanently eliminate MTrP pain, the underlying etiological factor (that causes latent MTrPs to become active ones) should also be identified and treated. The best clinical skills to identify the underlying etiological lesion (usually soft tissue lesion) are based on adequate knowledge in anatomy, kinesiology, and pathophysiology. The expensive and time consuming laboratory studies may not be necessary.

Language

English

First Page

1

Last Page

12

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