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 .
Endplate Potentials Are Common to Midfiber Myofacial Trigger Points
Simons DG , Hong C-Z , Simons LS : Endplate potentials are common to midfiber myofacial trigger points . Am J Phys Med Rehabil 2002;81:212–222 . Objective To compare the prevalence of motor endplate potentials ( noise and spikes ) in active central myofascial trigger points , endplate zones , and taut b and s of skeletal muscle to assess the specificity of endplate potentials to myofascial trigger points . Design This nonr and omized , unblinded needle examination of myofascial trigger points compares the prevalence of three forms of endplate potentials at one test site and two control sites in 11 muscles of 10 subjects . The endplate zone was independently determined electrically . Active central myofascial trigger points were identified by spot tenderness in a palpable taut b and of muscle , a local twitch response to snapping palpation , and the subject ’s recognition of pain elicited by pressure on the tender spot . Results Endplate noise without spikes occurred in all 11 muscles at trigger-point sites , in four muscles at endplate zone sites outside of trigger points ( P = 0.024 ) , and did not occur in taut b and sites outside of an endplate zone ( P = 0.000034 ) . Conclusion Endplate noise was significantly more prevalent in myofascial trigger points than in sites that were outside of a trigger point but still within the endplate zone . Endplate noise seems to be characteristic of , but is not restricted to , the region of a myofascial trigger point
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 .