Life has been tough for those of us with myofascial pain syndrome. We have too often been met with doctors who “don’t believe in” Chronic Myofascial Pain. We have been hampered by the lack of a scientifically credible and understandable cause for this condition and an officially recognized set of diagnostic criteria. This resulted in a lack of training of physicians and therapists. The insurance companies and the Social Security Administration made our lives even more difficult. This is about to change. We now have facts that cannot be disputed. At last we have proof that myofascial pain caused by trigger points is a true disease. We know what creates a trigger point, what it is, and many of the ways it can cause us pain and other symptoms. We know what causes those taut bands that constrict our muscles, and we know why our muscles become so tight that they hurt.
A myofascial trigger point is a localized area starving for oxygen. It creates an increased local energy demand. This local energy crisis releases neuroreactive biochemicals which sensitize nearby nerves. The sensitized nerves initiate the motor, sensory, and autonomic effects of myofascial trigger points by acting on the central nervous system. Muscles with trigger points are muscles in a constant state of energy crisis. Myofascial trigger points can be identified and documented electrophysiologically by characteristic spontaneous electrical activity (SEA). They may also be identified histologically (which means that the structure of the cells have changed) by contraction knots — the lumps and bumps we know only too well. We now have objective confirmation of electromyographic imaging of a myofascial trigger point. There is also ultrasound imaging of local twitch responses of trigger points, and biopsies of myofascial trigger points that show contraction knots and giant rounded muscle fibers. To quote from this article, "The endplate dysfunction characteristic of MTrPs involves both the nerve terminal and the postjunctional muscle fiber. This relationship identifies MTrPs as a neuromuscular disease." Simons DG. 1999. Diagnostic criteria of myofascial pain caused by trigger points. J Musculoskeletal Pain 7(1-2):111-120.
A myofascial trigger point is a localized area starving for oxygen. It creates an increased local energy demand. This local energy crisis releases neuroreactive biochemicals which sensitize nearby nerves. The sensitized nerves initiate the motor, sensory, and autonomic effects of myofascial trigger points by acting on the central nervous system. Muscles with trigger points are muscles in a constant state of energy crisis. Myofascial trigger points can be identified and documented electrophysiologically by characteristic spontaneous electrical activity (SEA). They may also be identified histologically (which means that the structure of the cells have changed) by contraction knots — the lumps and bumps we know only too well. We now have objective confirmation of electromyographic imaging of a myofascial trigger point. There is also ultrasound imaging of local twitch responses of trigger points, and biopsies of myofascial trigger points that show contraction knots and giant rounded muscle fibers. To quote from this article, "The endplate dysfunction characteristic of MTrPs involves both the nerve terminal and the postjunctional muscle fiber. This relationship identifies MTrPs as a neuromuscular disease." Simons DG. 1999. Diagnostic criteria of myofascial pain caused by trigger points. J Musculoskeletal Pain 7(1-2):111-120.
