diagnostic criteria for myofascial

Diagnostic Criteria for Myofascial Trigger Point Pain

An article in this month's Clinical Journal of Pain (2007 Mar-Apr;

23(3):278-86) summarizes the results of a literature review done at

the Uiversities of Exeter and Plymouth, UK. This review aimed to

investigate the criteria used to diagnose myofascial trigger point

(MTrP) pain syndrome, a painful condition often experienced by people

with fibromyalgia as well as those without. The researchers searched

electronic databases, looking for relevant empirical research, and

found 93 articles that met their inclusion criteria. They assessed

"(1) the individual criterion and criteria combinations used to

diagnose MTrP pain syndrome; (2) the cited "authoritative"

publications and (3) the criteria recommended by the authoritative

publications as being essential for MTrP pain syndrome diagnosis."

The review identified 19 different diagnostic criteria. The 4 most

commonly applied criteria were: "tender spot in a taut band" of

skeletalmuscle, "patient pain recognition," "predicted pain

referral pattern," and "local twitch response." There was no

consistent pattern to the choice of specific diagnostic criteria or

their combinations. However, one pair of criteria "tender point in

a taut band" and "predicted or recognized pain referral" were used

by over half the studies. The great majority of studies cited

publications by Travell and more recently Simons as a principal

authoritative source for MTrP pain syndrome diagnosis, yet most of

these studies failed to apply the diagnostic criteria as described

by these authorities.

They concluded that as there is not yet much consensus on the

definition and diagnosis of MTrP pain syndrome, further research is

necessary to test and evaluate the reliability of the diagnostic

criteria. Further, they suggest that until such reliable diagnostic

criteria are established, there should be "greater transparency in

research papers on how a case of MTrP pain syndrome is defined, and

claims for effective interventions in treating the condition

should be viewed with caution."