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肌筋膜疼痛综合征和触发点:肌肉骨骼疼痛患者的评估和治疗。

Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain.

机构信息

Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Manno.

Pain Management Center, Neurocenter of Southern Switzerland.

出版信息

Curr Opin Support Palliat Care. 2019 Sep;13(3):270-276. doi: 10.1097/SPC.0000000000000445.

Abstract

PURPOSE OF REVIEW

Myofascial pain syndrome is a chronic pain condition characterized by the presence of myofascial trigger point, a hyperirritable painful spot involving a limited number of muscle fibers. The literature suggest that myofascial trigger points should be considered peripheral pain generators and this critical review will summarize recent findings concerning the clinical evaluation and the treatment of myofascial trigger points.

RECENT FINDINGS

The clinical features of myofascial trigger points and their contribution to the patient pain and disability have been detailed in several recent studies, which support the clinical relevance of the condition. Recent studies reported that manual palpation to identify MTrPs has good reliability, although some limitations are intrinsic to the diagnostic criteria. During the last decade, a plethora of treatments have been proposed and positive effects on pain and function demonstrated.

SUMMARY

The myofascial trigger point phenomenon has good face validity and is clinically relevant. Clinicians are encouraged to consider the contribution of myofascial trigger points to the patient's pain and disability through a careful medical history and a specific manual examination. Patients with myofascial trigger points will benefit from a multimodal treatment plan including dry needling and manual therapy techniques. Internal and external validity of research within the field must be improved.

摘要

目的综述

肌筋膜疼痛综合征是一种慢性疼痛疾病,其特征是存在肌筋膜触发点,这是一种涉及少量肌纤维的高度敏感疼痛点。文献表明,肌筋膜触发点应被视为外周疼痛发生器,本综述将总结有关肌筋膜触发点的临床评估和治疗的最新发现。

最近的发现

几项最近的研究详细描述了肌筋膜触发点的临床特征及其对患者疼痛和残疾的贡献,这些研究支持了该疾病的临床相关性。最近的研究报告称,手动触诊来识别肌筋膜触发点具有良好的可靠性,尽管诊断标准存在一些固有局限性。在过去十年中,已经提出了大量的治疗方法,并证明对疼痛和功能有积极影响。

总结

肌筋膜触发点现象具有良好的表面效度,且与临床相关。临床医生应通过仔细的病史询问和特定的手法检查来考虑肌筋膜触发点对患者疼痛和残疾的影响。肌筋膜触发点患者将受益于包括干针和手法治疗技术在内的多模式治疗方案。该领域的研究必须提高内部和外部有效性。

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