Myofascial Pain and Fibromyalgia Syndromes

This book is a clear and comprehensive review of current knowledge concerning the myofascial trigger point pain syndrome and fibromyalgia. It covers the pathogenesis, pathophysiology, clinical manifestations and differential diagnosis of these two closely associated muscle pain disorders. A guide to specific treatment involving trigger points is outlined in detail and supported with clear illustrations.

Contents

Contributors
Foreword
Preface
Acknowledgements

PART 1. Myofascial trigger point pain syndromes - pathophysiology and management 1.
The evolution of current concepts
Terminological confusion
John Kellgren's observations
Myofascial trigger point pain syndromes
Fibromyalgia 2.
Relevant neurophysiological mechanisms
Original beliefs
Current concepts
Skin nociceptors
Muscle nociceptors
Transmission of nociceptive information to the brain
Pathways for centripetal transmission of nociceptive information
Brainstem's reticular formation
Pain-modulating mechanisms
Endogenous pain-suppressing substances
Myofascial trigger point pain-suppressing techniques 3.
The emotional aspects of pain
Emotional reactions to pain
Anxiety-induced MTrP pain
Pain-induced behaviour
Assessing the emotional component of organic pain
Psychogenic pain
Trauma-induced MTrP pain erroneously diagnosed as emotional in origin
Psychological effects of compensation-seeking on pain 4.
Myofascial trigger point pain
Morphology of skeletal muscle
Physiological mechanisms involved in voluntary muscle contraction
Pathophysiology of myofascial trigger points
Perpetuation of myofascial trigger point pain
Myofascial trigger point pain referral
The search for myofascial trigger points
Diagnosis of the MTrP pain syndrome 5.
Nociceptive nerve pain, neuropathic pain and myofascial trigger point pain
Pathophysiology of neuropathic pain
Clinical manifestations of pain of neural origin
Some diagnostic pitfalls
Management of pain of neural origin 6.
Concomitant complex regional pain and myofascial trigger point pain syndromes
Terminology
Aetiological factors common to RCPS type 1 (RSD) and the MTrP pain syndrome
Pain-producing mechanisms common to both the MTrP pain syndrome and CRPS type 1 (RSD)
Complex regional pain syndrome type 1 (RSD) 7.
Methods of treating myofascial trigger point pain
Deactivating myofascial trigger points
Clinical trials

PART 2. Regional myofascial trigger point pain syndromes 8.
The neck
Cervical myofascial trigger point pain syndrome
Cervical whiplash injuries
Cervical spondylosis
Cervical disc prolapse 9.
The shoulder
Primary referral of MTrP pain to the shoulder region
Secondary development of MTrP pain
Rotator cuff tendinitis
Associated disorders
Adhesive capsulitis 10.
The arm,/b>
Cervical radiculopathic and MTrP brachial pain - differential diagnosis
Brachial pain from TrPs in neck, shoulder girdle and chest wall muscles
Pain from TrPs in the forearm's supinator, brachioradialis and hand extensor muscles
Lateral epicondylitis (syn: tennis elbow)
Pain from TrPs in the forearm's hand and finger flexor muscles
Pain from TrPs in the palmaris longus and pronator teres muscles
Medial epicondylitis
Cubital tunnel syndrome
Carpal tunnel syndrome
Tenosynovitis of the wrist
Pain from MTrPs around the thumb
First carpometacarpal joint osteoarthritis
MTrP pain in the fingers
Osteoarthritic small joints of the hand
Management of the brachial MTrP pain syndrome
Repetitive strain injury
Sympathetically mediated brachial pain 11.
The head and face
Myofascial trigger point cephalalgia
Migraine
Tension-type headaches
Temporo-facial pain
Intra-articular temporomandibular joint pain
Extra-articular temporomandibular pain 12.
The lower back
Lumbar MTrP pain syndrome
Acute, recurrent and chronic lumbar MTrP pain
Lumbar facet joint pain
Lumbar facet joint syndrome
Lumbar disc herniation pain
Lumbar spondylosis
Degenerative spondylolisthesis
Lateral canal stenosis
Neurogenic claudication 13.
The lower limb
Pain from MTrPs in the anterior, lateral and medial aspects of the thigh
Pain from trigger points in the posterior thigh muscles
Pain from MTrPs in the anterior compartment of the leg
Pain from MTrPs in the lateral compartment of the leg
Pain from MTrPs in the superficial posterior compartment of the leg
Pain from MTrPs in the deep posterior compartment of the leg
Pain from MTrPs in the foot
Dorsal surface of the foot
Plantar surface of the foot 14.
The chest wall
Anterior chest wall MTrP pain syndrome
Differential diagnosis
Methods of investigating anterior chest wall pain
Posterior chest wall MTrP pain syndrome 15.
The anterior abdominal wall and pelvic floor
Incidence
Views concerning pathogenesis
Anterior abdominal wall MTrP pain syndrome
Pelvic MTrP pain

PART 3. The fibromyalgia syndrome 16.
Clinical characteristics and biopathophysiological mechanisms of fibromyalgia syndrome
Muhammad B Yunus and Fatma Inanici
Clinical characteristics
Biopathophysiological mechanisms of FMS
Disability and quality of life in FMS
Central sensitivity syndromes
Summary 17.
Management of fibromyalgia syndrome
Fatma Inanici and Muhammad B Yunus
Patient education and reassurance
Addressing aggravating factors
Non-pharmacological interventions
Pharmacological management
Tender point injections
Prognosis
Summary

Index