![travell and simons trigger pain point patterns travell and simons trigger pain point patterns](http://online.anyflip.com/gepce/ifwi/files/mobile/2.jpg)
30 This observation has been attributed to a spinal reflex, 27,29 becaue the response is abolished by motor nerve ablation or infusion of local anesthetic.
![travell and simons trigger pain point patterns travell and simons trigger pain point patterns](https://i5.walmartimages.com/asr/1efa7aa8-3fd2-4d0a-8e5d-78a4c4854dfc.992f18ebf2a76acdaee776271fff7a18.jpeg)
Endplate noise is significantly more prevalent in MTrPs than in sites that lie outside of an MTrP but still within the endplate zone. 29 The twitch response accompanied by a burst of electrical activity (e.g., endplate noise) within the muscle band contains the activated trigger point, whereas no activity is seen at other muscle bands. Mechanical stimulation (“snapping” palpation, pressure, or needle insertion) can elicit a local twitch response frequently accompanied by referred pain. This local response is considered a characteristic finding of the MTrP. 28 One such feature of the MTrP is the so-called twitch response. 27 Equine MTrPs have also been identified with similar features to those documented in humans and rabbits with the exception that referred pain patterns cannot be determined in animals. Animal studies reported myofascial trigger spots (MTrSs) in taut bands of rabbit muscle fibers similar to that observed in human MTrP in several respects. Childers, in Botulinum Toxin, 2009 Features of Myofascial Trigger PointsĬharacteristic features of MTrPs have been described in both human and animal studies. Sterile solutions may be injected into MTrPs to deactivate them in the same manner as aquapuncture.
![travell and simons trigger pain point patterns travell and simons trigger pain point patterns](https://d1w7fb2mkkr3kw.cloudfront.net/assets/images/book/lrg/9781/9751/9781975184353.jpg)
In addition, it is likely that most Ashi points are actually trigger points. Many acupuncture points have been found to correlate with common trigger point locations ( Table 18-2). 28 Although MTrPs can vary in location, there are well documented areas in the body where trigger points commonly occur. As demonstrated by studies by Melzack and colleagues in 1981 and Dosher in 2006, there is significant overlap between MTrPs and acupuncture points. Needling of sensitive areas in the body such as MTrPs may correlate with the acupuncture technique of needling “Ashi” points, which are defined as tender or sensitive points. Dry needling of MTrPs can offer immediate and long-lasting relief of chronic soft-tissue pain. 22 Inactivation of MTrPs can be achieved via insertion of an acupuncture needle directly at the site of the trigger point. The noxious stimuli relayed by trigger points are known to be one of the most common causes of musculoskeletal pain, yet they are largely underdiagnosed and undertreated. 6, 28 MTrPs may be caused by multiple factors including direct trauma, chronic or repetitive overuse of the muscle, or psychological stress. Myofascial trigger points (MTrPs) are hyper-reactive taut bands or nodules found in skeletal muscles that elicit a characteristic twitch response on palpation and cause referred pain. Leilani Alvarez, in Handbook of Veterinary Pain Management (Third Edition), 2015 Trigger Point Acupuncture However, further MRI needs to be conducted in other muscle groups before reaching firm conclusions. The presence of muscle atrophy in RCP minor suggests that such atrophy could occur in other active MTPs. These investigations support previous inference that active MTPs in sub-occipital muscles might contribute to headache. It was hypothesized that muscle atrophy of the RCP minor was associated with active MTPs and CTTH. The cross-sectional area of RCP minor was significantly smaller in those with active MTPs compared to those with latent MTPs. Active MTPs were found in 55% of patients and the rest had latent MTPs. A subsequent study was conducted in 11 subjects to evaluate the cross-sectional area of the RCP major and minor with MRI and its relationship with active MTPs in chronic tension-type headache (CTTH) patients ( Fernandez de las Penas et al 2008). Of the ETTH patients, 60% had active MTPs which reproduced their symptoms while the rest had latent MTPs. In one study, 10 patients with ETTH were compared with 10 asymptomatic controls for the presence of sub-occipital MTPs. Clinical investigations demonstrate that MTPs in the sub-occipital muscles may be associated with episodic tension-type headache (ETTH) ( Fernandez de las Penas et al 2006c). The MTPs in the sub-occipital muscles may refer pain to the occiput and temporal region and cause bilateral headache ( Simons et al 1999). Myofascial trigger points may occur in the mid belly of both RCP major and minor and inferior oblique. Kerrie Bolton, Peter Selvaratnam, in Headache, Orofacial Pain and Bruxism, 2009 Trigger point location