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Do you think it's really possible to diagnose myofascial pain syndrome by poking people's muscles? That's the only test I had. It seems like there should be some other testing.
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Myofascial pain syndrome (MPS) is an overuse or muscle stress syndrome. MPS is diagnosed by the presence of myofascial trigger points (TrPs). These are irritable spots within a tight band of muscle.
When pressing any of these points, a typical pattern of local and referred pain occurs. Referred pain means pain develops at quite a distance from the points of local tenderness.
The examiner may also feel a ropelike area within a muscle. Sometimes pressing on this nodule causes crackling or grating called crepitus. Inside the area in question, there may be fibrotic tissue present resembling a small pea. This spot is usually very, very tender spot.
Using the hands to feel the tissues is really the main diagnostic tool doctors and therapists use to identify TrPs. Besides reproducing the patient's pain, palpation of the TrP can also cause a local twitch response. You and the examiner can see the muscle twitch causing some part of the anatomy (e.g., finger, wrist) to move involuntarily.
The same test method also causes a jump sign. When pressure is applied to the trigger point, the patient yells ouch and jumps away from the examiner. These two signs are usually present, observable, and reproducible in anyone with TrPs from MPS.
Besides the pain, there may be reduced range of motion for joints under the control of the involved muscle along with muscle weakness. The patient may report numbness or paresthesia rather than pain.
The absence of certain symptoms is also diagnostic. There are no neurologic abnormalities. Systemic signs and symptoms are absent (no fever, chills, nausea, vomiting, and so on).
There may be some changes in motor function caused by TrPs. These can include spasm of other muscles, weakness of the involved muscle function, loss of coordination by the involved muscle, and decreased work tolerance of the involved muscle.
All in all, the clinician begins with palpation as the main exam tool. But a global assessment is needed. This type of diagnostic eval includes patient report of pain and pain patterns and the presence of a local twitch response and/or the jump sign.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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