Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.

The intent of this article is to discuss the evolving role of the myofascial trigger point (MTrP) in myofascial pain syndrome (MPS) from both a historical and scientific perspective. MTrPs are hard, discrete, palpable nodules in a taut band of skeletal muscle that may be spontaneously painful (i.e., active) or painful only on compression (i.e., latent). MPS is a term used to describe a pain condition that can be acute or, more commonly, chronic and involves the muscle and its surrounding connective tissue (e.g. fascia). According to Travell and Simons, MTrPs are central to the syndrome-but are they necessary? Although the clinical study of muscle pain and MTrPs has proliferated over the past two centuries, the scientific literature often seems disjointed and confusing. Unfortunately, much of the terminology, theories, concepts, and diagnostic criteria are inconsistent, incomplete, or controversial. To address these deficiencies, investigators have recently applied clinical, imaging (of skeletal muscle and brain), and biochemical analyses to systematically and objectively study the MTrP and its role in MPS. Data suggest that the soft tissue milieu around the MTrP, neurogenic inflammation, sensitization, and limbic system dysfunction may all play a role in the initiation, amplification, and perpetuation of MPS. The authors chronicle the advances that have led to the current understanding of MTrP pathophysiology and its relationship to MPS, and review the contributions of clinicians and researchers who have influenced and expanded our contemporary level of clinical knowledge and practice.

Myofascial Pain Syndrome, myofascial trigger points and trigger points in veterinary medicine: a review / Revisão: Síndrome Dolorosa Miofascial, pontos gatilhos miofascial e pontos gatilhos na medicina veterinária

Myofascial Pain Syndrome (MPS) a is a painful condition related to myofascial trigger points (TP) in skeletal muscle. The aim of this study was to perform a literature review on the etiology, pathophysiology, diagnosis and treatment of MPS in veterinary medicine. The research sites used for this purpose were: Scientific Electronic Library, PubMed and Medline. The inclusion criteria for the papers were: must be written in English; published between 1990 and 2018; include the following keywords: myofascial pain syndrome veterinary/dog/canine/cat/feline/horse/equine, trigger points veterinary/dog/canine/cat/feline/horse/equine. Through the review, it was observed that veterinary clinical studies are scarce, and the articles found lack information such as MPS description, incidence and specific treatment techniques in dogs and horses, and no studies in cats were found.(AU)

Síndrome Dolorosa Miofascial (SDM) é uma condição dolorosa relacionada aos pontos gatilhos miofasciais (PG) no músculo esquelético. Este trabalho tem como objetivo realizar uma revisão bibliográfica sobre a etiologia, fisiopatogenia, diagnóstico e tratamento na medicina veterinária. Foram utilizados sites de pesquisas Scientific Electronic Library, Pubmed e Medline. Os critérios de inclusão estabelecidos foram: ser escrito em inglês; no período de 1990 a 2018; ter as palavras chaves para busca: myofascial pain syndrome veterinary/dog/canine/cat/feline/ horse/equine, trigger points veterinary/dog/canine/cat/feline/horse/equine. Após a revisão observa-se que faltam estudos clínicos em medicina veterinária, sendo que os artigos encontrados se limitam à descrição, incidência e técnicas pontuais em cães e equinos, não sendo encontradas referencias em felinos.(AU)

Tender points: evolution of concepts of the fibrositis/fibromyalgia syndrome.

The association of chronic pain, exhaustion, and multiple somatic complaints with apparent physical good health and long survival has a long history. The syndrome was called by many names including neuresthenia, rheumatism, and invalidism. When skeletal pain and stiffness were prominent, many observers recorded the existence of sites of tenderness and sometimes of areas of induration. The work of Lewis and Kellgren provided an experimentally reproducible method of study of the phenomena of referred pain and referred tenderness, which led to hypotheses about the nature of many of these syndromes, which were unfortunately too numerous and often contradictory. More recently, it has been learned that the sites of tenderness are precisely predictable in location and, under some circumstances, experimentally inducible. They are unknown to the patient and, therefore, due to mechanisms other than distortions of interpretation. The association with a variety of forms of sleep disturbance was discovered. These events have permitted the rapid evolution of controlled, numerical studies of these associations, which are reviewed briefly in this article.

[Fibromyalgia--a new name of an old "malady". Fatigue and pain syndrome with a historical background]. / Fibromyalgi--nytt namn på gammal "sjuka". Trötthets- och smärtsyndrom med historisk bakgrund.

Fibromyalgia is a good illustration of the fact that a smart new name of an old malady can spread like wildfire if well matched in time socioculturally. "Muscular rheumatism" has earlier been looked upon as a (rheumatic) inflammation of muscle cells or of muscular connective tissue. During the last decades the interest of leading clinicians and researchers have been directed against the pain perceiving system, suggesting defect pain modulating mechanisms peripherally and centrally. Fibromyalgia seems to supply several medical and social needs in our time and might be called a "fin-de-siècle" disease.

Raymond L. Nimmo and the evolution of trigger point therapy, 1929-1986.

Dr. Raymond L. Nimmo (1904-86) was the definitive chiropractic pioneer in the now widely accepted field of soft tissue and trigger point therapy. This article explores how Nimmo was able to make the radical conceptual leap from moving bones to working with muscles that move the bones. Also discussed are the neurophysiological explanations that Nimmo evolved in the 1950s for the trigger point phenomenon, formulations that are still regarded as highly sophisticated half a century later. Finally, the article describes how Nimmo, with a basic chiropractic education absent much of the background in the biological and physical sciences of today's preparation, was able to combine his clinical experiences and intellectual formulation to arrive at a theory that became widely accepted.

Disturbios osteo-musculares relacionados ao trabalho / Cummulative trauma disorders

Dor, especialmente nos membros superiores relacionada as atividades laborais, e condicao comum. Decorre geralmente de anormalidades musculo-esqueleticas e neurais. Alem das condicoes mecanicas admite-se que ...