Identification and quantification of myofascial taut bands with magnetic resonance elastography
PainSci summary of Chen 2007 ★★★☆☆?3-star ratings are for average studies, with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
This paper demonstrates the use of a promising new method of imaging the taut bands of muscle associated with myofascial trigger points, using a modification of MRI technology. It is thoroughly analyzed by Simons, who writes that this technology “may open a whole new chapter in the centuries-old search for a convincing demonstration of the cause of MTP symptoms.”
This was a small proof-of-concept experiment, testing the technology on gelatin models and then two subjects. They continued with more subjects in 2008 (see Chen et al).
OBJECTIVE: To explore the feasibility of using a new magnetic resonance imaging (MRI) technique--magnetic resonance elastography (MRE)--to identify and quantitate the nature of myofascial taut bands.
DESIGN: This investigation consisted of 3 steps. The first involved proof of concept on gel phantoms, the second involved numeric modeling, and the third involved a pilot trial on 2 subjects. Imaging was performed with a 1.5 T MRI machine. Shear waves were produced with a custom-developed acoustically driven pneumatic transducer with gradient-echo image collection gated to the transducer's motion. Shear wave propagation were imaged by MRE.
SETTING: An MRI research laboratory.
PARTICIPANTS: Two women, one with a 3-year history of myofascial pain and the other serving as the control.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: MRE images, finite element analysis calculations, and tissue and phantom stiffness determinations.
RESULTS: Results of the phantom measurements, finite element calculations, and study patients were all consistent with the concept that taut bands are detectable and quantifiable with MRE imaging. The findings in the subjects suggest that the stiffness of the taut bands (9.0+/-0.9 KPa) in patients with myofascial pain may be 50% greater than that of the surrounding muscle tissue.
CONCLUSIONS: Our findings suggest that MRE can quantitate asymmetries in muscle tone that could previously only be identified subjectively by examination.
- “Microscopic features and transient contraction of palpable bands in canine muscle,” an article in Am J Phys Med, 1976.
- “Endplate potentials are common to midfiber myofacial trigger points,” an article in Am J Phys Med Rehabil, 2002.
- “Accelerated muscle fatigability of latent myofascial trigger points in humans,” an article in Pain Med, 2012.
- “Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study,” an article in Ultrason Imaging, 2015.
- “Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points,” an article in Exp Brain Res, 2008.
- “Assessment of myofascial trigger points (MTrPs): a new application of ultrasound imaging and vibration sonoelastography,” an article in Conf Proc IEEE Eng Med Biol Soc, 2008.
- “Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome,” an article in Journal of Bodywork & Movement Therapies, 2008.
- “Ability of magnetic resonance elastography to assess taut bands,” an article in Clin Biomech (Bristol, Avon), 2008.
Specifically regarding Chen 2007:
- “New Views of Myofascial Trigger Points: Etiology and Diagnosis,” an article in Archives of Physical Medicine & Rehabilitation, 2008.
These three articles on PainScience.com cite Chen 2007 as a source:
- PS Trigger Points & Myofascial Pain Syndrome — A guide to the unfinished science of muscle pain, with reviews of every theory and self-treatment and therapy option
- PS Toxic Muscle Knots — Research suggests myofascial trigger points may be quagmires of irritating molecules
- PS The Trigger Point Identity Crisis — The biological evidence that a trigger point is a lesion in muscle tissue