The myofascial trigger point region: correlation between the degree of irritability and the prevalence of endplate noise
PainSci summary of Kuan 2007?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. ★★★☆☆?3-star ratings are for typical 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 study constitutes good replication of a 2002 study (see Simons) identifying an association between endplate noise or spontaneous electrical activity (SEA) and the clinical phenomenon of “trigger points.” In 32 patients with trapezius trigger points, they found endplate noise at the location of the putative trigger points, but not in adjacent muscle, concluding that “The irritability of an MTrP is highly correlated with the prevalence of endplate noise in the MTrP region of the upper trapezius muscle.”
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.
OBJECTIVE: This study was designed to investigate the correlation between the irritability of the myofascial trigger point (MTrP) and the prevalence of endplate noise (EPN) in the MTrP region of human skeletal muscle.
DESIGN: Twenty normal subjects with latent MTrPs and 12 patients with active MTrPs in the upper trapezius muscles were recruited for this study. The patients reported the subjective pain intensity of the active MTrP (0-10). The MTrP and an adjacent non-MTrP site were confirmed and marked for the measurement of pressure pain threshold (with a pressure algometer) and the prevalence of EPN (with electromyographic recordings).
RESULTS: The prevalence of EPN in the MTrP regions was significantly higher (P < 0.01) in the active MTrPs than in the latent ones. However, no EPN could be found in the non-MTrP region near either the active or the latent MTrPs. The pain intensity and the pressure pain threshold were highly correlated with the prevalence of EPN in the MTrP region (r = 0.742 and -0.716, respectively).
CONCLUSIONS: The irritability of an MTrP is highly correlated with the prevalence of EPN in the MTrP region of the upper trapezius muscle. The assessment of EPN prevalence in an MTrP region may be applied to evaluate the irritability of that MTrP.
related content
- “Endplate potentials are common to midfiber myofacial trigger points,” David G Simons, Chang-Zern Hong, and Lois Statham Simons, 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,” Yueh-Ling Hsieh, Li-Wei Chou, Yie-San Joe, and Chang-Zern Hong, Archives of Physical Medicine & Rehabilitation, 2011.
- “Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation,” Hong-You Ge, César Fernández-de-Las-Peñas, and Shou-Wei Yue, Chin Med, 2011.
These two articles on PainScience.com cite Kuan 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 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:
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.