4module 4.4 examination slides

8/11/2019 4Module 4.4 Examination Slides

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Myofascial Pain

Bernadette Jaeger DDS

Adjunct ProfessorSchools of Medicine and DentistryUniversity of California, Los Angeles

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1. Localized, tender “spot” or nodule

2. in a taut band of skeletal muscle

3. with a local twitch response (LTR)

4. and associated referred pain.

5. Clinically, reproduction of usual pain.



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or nodule







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0)&-+,) ./ 2,#33), 4.#$* 5)$-#9:#*1Reeves JL, Jaeger B, Graff-Radford SB Pain (24) 313-324; 1986

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8AB&%)$* 8,)&-Hong et al: J Musculoskeletal Pain 4(3)61-79, 1996



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Measurement Location TrP Non-TrP

Superficial Masseter* 2.73 3.13

Anterior Temporalis** 2.87 3.57

Splenius Capitis* 2.66 3.51

Trapezius** 3.69 4.65

Semispinalis Capitis* 3.63 4.07

* p < .05** p < 0.01

*** Sensitivity measured in kg/cm2

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Easily palpated

•

Common in normal control subjects•

Rabbit model exists

•

Depend on an intact nerve supply

• Contain the trigger point

Relaxedmuscle fibers

Taut band

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Responsive Band

Hong C-Z, Torigoe Y, 1994



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•

Demonstrated by EMG

•

Rabbit model exists

•

Localized to the taut

band

•

Best elicited at the TrP

•

Spinal cord reflex

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2,#33), 4.#$* 7I&@#$&9.$Based on the algometry data, palpation

requires up to 2-4 kilograms per square

centimeter of pressure to elicit pain response.

Up to 2-4 kg/cm2



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Based on the documented delay in emergence

of the referred pain patterns, and Mense’s

theory of “unmasking latent connections” in the

spinal cord, palpation pressure should be held

for at least 10-15 seconds to allow the referral

pattern to develop.

10-15 seconds

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Recognition and appropriate

management are essential for

successful treatment outcomes.

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4module 4.4 examination slides

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