travell and simons trigger points research

The chronic pain diagnostic taxonomy published by the International Association for the Study of Pain provides no specific criteria for the diagnosis of MPS rather, it offers a note that the diagnosis depends upon the demonstration of a trigger point and reproduction of pain by maneuvers which place stress upon proximal structures or nerve roots. This syndrome presents clinically as referred pain, a limited range of motion in joints, and a local twitch response following mechanical stimulation of certain muscular and fascial areas, known as myofascial trigger points (MTrPs), and is associated with motor endplates. MPS is defined as a focal hyperirritability in muscle tissue. Myofascial pain syndrome (MPS) is the most frequent cause of chronic musculoskeletal pain, with estimates of world-wide prevalence ranging from 0.5% to 5.0%. This type of clinical correlation between spinal accessory nerve branching and MTrP is useful to achieve a better understanding of the anatomical correlation of MTrP and the physiopathology of these disorders and may provide a scientific basis for their treatment, rendering useful additional information to therapists to achieve better diagnoses and improve therapeutic approaches. The four points were common in these twelve cadavers. Seven points are described, four of which are motor points: in all cases, these locations corresponded to clinically described MTrPs. Dissection was performed through stratigraphic layers to preserve the motor innervation of the trapezius muscle, which is located deep in the muscle.

Both trapezius muscles from twelve adult cadavers were carefully dissected by the authors (anatomy professors and medical graduate students) to observe the exact point where the branches of the spinal accessory nerve entered the muscle belly. Although anatomoclinical correlations represent a major feature of MTrP, no previous reports describing the distribution of the accessory nerve branches and their anatomical relationship with MTrP are found in the literature. This study aimed to bring the trapezius muscle knowledge of the locations where the accessory nerve branches enter the muscle belly to reach the motor endplates and find myofascial trigger points (MTrPs).

Travell and simons trigger points research