PainSci summary of Simons 1976?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 of trigger points in canine cadavers shows histologic changes that are consistent with theoretically predicted trigger point morphology. Specifically, it clearly showed a strongly contracted segment of muscle fibre — not the whole fiber, but just a very small part of it. The segment is clearly swollen, and the sarcomere bands are so tightly packed that individual ones can’t be seen — but they are clearly visible on either side of the contraction, and in adjacent fibres.
The authors assume that there are compressed capillaries on either side of the contraction. If so, this would probably deprive the tissue of oxygen.
The tissue examined was not symptomatic — dogs can’t tell us where it hurts. The spots were identified as taut bands with a local twitch response prior to (gulp) termination of the specimen.
While the results seem to be consistent with the MTrP construct, it was not — and could not be — correlated with the symptomatology that clinically defines it.
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.
Ten pairs of biopsies were excised from gracilis and semitendinosus muscles of 4 mongrel dogs. These were compared with the histological findings reported in painful spots and muscle hardenings of human muscles. Test biopsies sampled a palpable band. Paired control biopsies sampled a portion of the same muscle where it showed no palpable hardening. Processed sections were randomized and read blind. Sections stained with aqueous toluidine blue showed no convincing metachromasia. Sections stained with trichrome showed no proliferation of endomysial connective tissue. Test sections stained with hematoxylin and eosin showed no proliferation of nuclei and no increase in the number of central nuclei in muscle fibers compared to control sections. No convincing histological difference was found. During surgery under Nembutal anesthesia, rubbing palpation of the exposed muscle elicited a transient contraction of a bundle of muscle fibers several milli-meters in diameter. This corresponded in time and position to the palpable band in the dog muscle. The band-like hardness palpated in these canine muscles appears to be caused by a circumscribed transient muscular contraction rather than histologically demonstrable structural changes.
- “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.
- “Accelerated muscle fatigability of latent myofascial trigger points in humans,” Hong-You Ge, Lars Arendt-Nielsen, and Pascal Madeleine, 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,” Cristina Emöke Erika Müller, Maria Fernanda Montans Aranha, and Maria Beatriz Duarte Gavião, Ultrason Imaging, 2015.
- “Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points,” Hong-You Ge, Yang Zhang, Shellie Boudreau, Shou-Wei Yue, and Lars Arendt-Nielsen, Exp Brain Res, 2008.
- “Assessment of myofascial trigger points (MTrPs): a new application of ultrasound imaging and vibration sonoelastography,” Siddhartha Sikdar, Jay P Shah, Elizabeth Gilliams, Tadesse Gebreab, and Lynn H Gerber, 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,” Jay P Shah and Elizabeth A Gilliams, Journal of Bodywork & Movement Therapies, 2008.
- “Ability of magnetic resonance elastography to assess taut bands,” Qingshan Chen, Jeffrey Basford, and Kai-Nan An, Clin Biomech (Bristol, Avon), 2008.
- “Identification and quantification of myofascial taut bands with magnetic resonance elastography,” Qingshan Chen, Sabine Bensamoun, Jeffrey R Basford, Jeffrey M Thompson, and Kai-Nan An, Archives of Physical Medicine & Rehabilitation, 2007.
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.