Mense S
CBTM, Neuroanatomie, Medizin. Fakultät Mannheim, Universität Heidelberg, Ludolf-Krehl-Str. 13-17, 68167 Mannheim, Deutschland.
Schmerz. 2011 Feb;25(1):93-103; quiz 104. doi: 10.1007/s00482-010-0965-4.
The article describes and compares the characteristics of myofascial trigger points (MTrPs) of the myofascial pain syndrome and the tender points (TePs) of the fibromyalgia syndrome. Many statements are hypothetical, because not all aspects of the disorders have been clarified in solid studies. Signs and symptoms of MTrPs: (1) palpable nodule, often located close to the muscle belly, (2) often single, (3) allodynia and hyperalgesia at the MTrP, (4) referral of the MTrP pain, (5) normal pain sensitivity outside the MTrPs, (6) local twitch response, (7) local contracture in biopsy material, (8) peripheral mechanism probable. Signs and symptoms of TePs: (1) no palpable nodule, (2) location often close to the muscle attachments, (3) multiple by definition, (4) allodynia and hyperalgesia also outside the TePs, (5) enhanced pain under psychic stress, (6) unspecific histological changes in biopsy material, (7) central nervous mechanism probable. The multitude of differences speak against a common aetiology and pathophysiology.
本文描述并比较了肌筋膜疼痛综合征的肌筋膜触发点(MTrP)和纤维肌痛综合征的压痛点(TeP)的特征。许多说法是假设性的,因为这些病症的所有方面尚未在可靠研究中得到阐明。MTrP的体征和症状:(1)可触及的结节,常位于肌腹附近,(2)通常为单个,(3)MTrP处存在痛觉过敏和超敏反应,(4)MTrP疼痛的牵涉痛,(5)MTrP以外区域的疼痛敏感性正常,(6)局部抽搐反应,(7)活检材料中的局部挛缩,(8)可能存在外周机制。TeP的体征和症状:(1)无可触及的结节,(2)位置常靠近肌肉附着点,(3)根据定义为多个,(4)TeP以外区域也存在痛觉过敏和超敏反应,(5)心理压力下疼痛加剧,(6)活检材料中存在非特异性组织学变化,(7)可能存在中枢神经机制。众多差异表明不存在共同的病因和病理生理学。