title: Myofascial pain syndromes and their evaluation.
abstract: This article reviews the available published knowledge about the diagnosis, pathophysiology and treatment of myofascial pain syndromes from trigger points. Furthermore, epidemiologic data and clinical characteristics of these syndromes are described, including a detailed account of sensory changes that occur at both painful and nonpainful sites and their utility for diagnosis and differential diagnosis; the identification/diagnostic criteria available so far are critically reviewed. The key role played by myofascial trigger points as activating factors of pain symptoms in other algogenic conditions--headache, fibromyalgia and visceral disease--is also addressed. Current hypotheses on the pathophysiology of myofascial pain syndromes are presented, including mechanisms of formation and persistence of primary and secondary trigger points as well as mechanisms beyond referred pain and hyperalgesia from trigger points. Conventional and most recent therapeutic options for these syndromes are described, and their validity is discussed on the basis of results from clinical controlled studies.
authors.affiliation: Ce.S.I, G. D'Annunzio Foundation, Department of Medicine and Science of Aging, Chieti University, via Carlo de Tocco n. 3, Chieti, Italy. mag@unich.it
authors.forename: Maria Adele
authors.initials: MA
authors.lastname: Giamberardino
authors.forename: Giannapia
authors.initials: G
authors.lastname: Affaitati
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fabrizio
authors.forename: Raffaele
authors.initials: R
authors.lastname: Costantini
mesh_terms: D000698:Analgesia / Q000379:methods; D002986:Clinical Trials as Topic; D005356:Fibromyalgia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006261:Headache / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009209:Myofascial Pain Syndromes / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D059408:Pain Management / Q000379:methods*; D053591:Referred Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D013577:Syndrome; D061028:Trigger Points / Q000503:physiopathology*; D059265:Visceral Pain / Q000473:pathology