Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation
PainSci summary of Ge 2011?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★☆☆☆?2-star ratings are for studies with flaws, bias, and/or conflict of interest; published in lesser journals. 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 is a wordy, technical review of “new evidence” of the role of spontaneous electrical activity (SEA) in trigger points, but it’s not clear what the new evidence is, and there doesn’t seem to be much direct, credible evidence on the topic at all: just a handful of old and/or animal studies, and maybe a single more recent (2007) paper of interest, Kuan. Most of the paper appears to be general discussion of the etiology of trigger points.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activity at myofascial trigger point originates from the extrafusal motor endplate. The spontaneous electrical activity represents focal muscle fiber contraction and/or muscle cramp potentials depending on trigger point sensitivity. Local pain and tenderness at myofascial trigger points are largely due to nociceptor sensitization with a lesser contribution from non-nociceptor sensitization. Nociceptor and non-nociceptor sensitization at myofascial trigger points may be part of the process of muscle ischemia associated with sustained focal muscle contraction and/or muscle cramps. Referred pain is dependent on the sensitivity of myofascial trigger points. Active myofascial trigger points may play an important role in the transition from localized pain to generalized pain conditions via the enhanced central sensitization, decreased descending inhibition and dysfunctional motor control strategy.
related content
- “Endplate potentials are common to midfiber myofacial trigger points,” an article in Am J Phys Med Rehabil, 2002.
- “Spinal cord mechanism involving the remote effects of dry needling on the irritability of myofascial trigger spots in rabbit skeletal muscle,” an article in Archives of Physical Medicine & Rehabilitation, 2011.
- “The myofascial trigger point region: correlation between the degree of irritability and the prevalence of endplate noise,” an article in Am J Phys Med Rehabil, 2007.
These two articles on PainScience.com cite Ge 2011 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 The Trigger Point Identity Crisis — The biological evidence that a trigger point is a lesion in muscle tissue
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
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- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.
- Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis. Zhong 2017 Pain Physician.