title: An expansion of Simons' integrated hypothesis of trigger point formation.
abstract: Simons' integrated hypothesis proposed a model of trigger point (TrP) activation to explain known TrP phenomena, particularly endplate noise. We propose an expansion of this hypothesis to account for new experimental data and established muscle pathophysiology.
authors.affiliation: Johns Hopkins University Pain and Rehabilitation Medicine, Bethesda, MD 20814-2432, USA. gerwin@painpoints.com
authors.forename: Robert D
authors.initials: RD
authors.lastname: Gerwin
authors.forename: Jan
authors.initials: J
authors.lastname: Dommerholt
authors.forename: Jay P
authors.initials: JP
authors.lastname: Shah
mesh_terms: D000109:Acetylcholine / Q000378:metabolism; D000110:Acetylcholinesterase / Q000502:physiology; D000818:Animals; D015740:Calcitonin Gene-Related Peptide / Q000502:physiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D009045:Motor Endplate / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000293:injuries / Q000378:metabolism / Q000503:physiopathology; D009209:Myofascial Pain Syndromes / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D009619:Nociceptors / Q000502:physiology; D011950:Receptors, Cholinergic / Q000502:physiology
chemical_list: D011950:Receptors, Cholinergic; D000110:Acetylcholinesterase; D015740:Calcitonin Gene-Related Peptide; D000109:Acetylcholine