On the basis of the limited number of studies available , and significant problems with their design , reporting , statistical integrity , and clinical applicability , physical examination can not currently be recommended as a reliable test for the diagnosis of trigger points .
BACKGROUND Trigger points are promoted as an important cause of musculoskeletal pain .
There is no accepted reference st and ard for the diagnosis of trigger points , and data on the reliability of physical examination for trigger points are conflicting .
OBJECTIVES To systematic ally review the literature on the reliability of physical examination for the diagnosis of trigger points .
Interexaminer reliability of the palpation of trigger points in the trunk and lower limb muscles.
OBJECTIVES To determine the interexaminer reliability of palpation of three characteristics of trigger points ( taut b and , local twitch response , and referred pain ) in patients with subacute low back pain , to determine whether training in palpation would improve reliability , and whether there was a difference between the physiatric and chiropractic physicians . DESIGN Reliability study . SETTING Whittier Health Campus , Los Angeles College of Chiropractic . PARTICIPANTS Twenty-six nonsymptomatic individuals and 26 individuals with subacute low back pain . INTERVENTION Twenty muscles per individual were first palpated by an expert and then r and omly by four physician examiners . MAIN OUTCOME MEASURES Palpation findings . RESULTS Kappa scores for palpation of taut b and s , local twitch responses , and referred pain were .215 , .123 , and .342 , respectively , between the expert and the trained examiners , and .050 , .118 , and .326 , respectively , between the expert and the untrained examiners . Kappa scores for agreement for palpation of taut b and s , twitch responses , and referred pain were .108 , -.001 , and .435 , respectively , among the nonexpert , trained examiners , and -.019 , .022 , and .320 , respectively , among the nonexpert , untrained examiners . CONCLUSIONS Among nonexpert physicians , physiatric or chiropractic , trigger point palpation is not reliable for detecting taut b and and local twitch response , and only marginally reliable for referred pain after training
On the basis of the limited number of studies available , and significant problems with their design , reporting , statistical integrity , and clinical applicability , physical examination can not currently be recommended as a reliable test for the diagnosis of trigger points .
BACKGROUND Trigger points are promoted as an important cause of musculoskeletal pain .
There is no accepted reference st and ard for the diagnosis of trigger points , and data on the reliability of physical examination for trigger points are conflicting .
OBJECTIVES To systematic ally review the literature on the reliability of physical examination for the diagnosis of trigger points .