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 .
Chronic low back pain in older adults: prevalence, reliability, and validity of physical examination findings.
OBJECTIVES To develop a structured physical examination protocol that identifies common biomechanical and soft-tissue abnormalities for older adults with chronic low back pain ( CLBP ) that can be used as a triage tool for healthcare providers and to test the interobserver reliability and discriminant validity of this protocol . DESIGN Cross-sectional survey and examination . SETTING Older adult pain clinic . PARTICIPANTS One hundred eleven community-dwelling adults aged 60 and older with CLBP and 20 who were pain-free . MEASUREMENTS Clinical history for demographics , pain duration , previous lumbar surgery or advanced imaging , neurogenic claudication , and imaging clinical ly serious symptoms . Physical examination for scoliosis , functional leg length discrepancy , pain with lumbar movement , myofascial pain ( paralumbar , piriformis , tensor fasciae latae ( TFL ) ) , regional bone pain ( sacroiliac joint ( SIJ ) , hip , vertebral body ) , and fibromyalgia . RESULTS Scoliosis was prevalent in those with ( 77.5 % ) and without pain ( 60.0 % ) , but prevalence of SIJ pain ( 84 % vs 5 % ) , fibromyalgia tender points ( 19 % vs 0 % ) , myofascial pain ( 96 % vs 10 % ) , and hip pain ( 48 % vs 0 % ) was significantly different between groups ( P < .001 ) . Interrater reliability was excellent for SIJ pain ( 0.81 ) , number of fibromyalgia tender points ( 0.84 ) , and TFL pain ( 0.81 ) ; good for scoliosis ( 0.43 ) , kyphosis ( 0.66 ) , lumbar movement pain ( 0.75 ) , piriformis pain ( 0.71 ) , and hip disease by internal rotation ( 0.56 ) ; and marginal for leg length ( 0.00 ) and paravertebral pain ( 0.39 ) . CONCLUSION Biomechanical and soft tissue pathologies are common in older adults with CLBP , and many can be assessed reliably using a brief physical examination . Their recognition may save unnecessary healthcare expenditure and patient suffering
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 .