New trends in myofascial pain syndrome.

Chang-Zern Hong
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Abstract

This review article summarizes recent studies on myofascial trigger point (MTrP) to further clarify the mechanism of MTrP. MTrP is the major cause of muscle pain (myofascial pain) in clinical practice. There are multiple MTrP loci in an MTrP region. An MTrP locus contains a sensory component (sensitive locus) and a motor component (active locus). A sensitive locus is the site from which pain, referred pain (ReP), and local twitch response (LTR) can be elicited by needle stimulation. Sensitive loci are probably sensitized nociceptors based on a histological study. They are widely distributed in the whole muscle, but are concentrated in the endplate zone. An active locus is the site from which spontaneous electrical activity (SEA) can be recorded. Active loci are dysfunctional endplates since SEA is essentially the same as endplate noise (EPN) recorded from an abnormal endplate as reported by neurophysiologists. Both ReP and LTRs are mediated through spinal cord mechanisms, demonstrated in both human and animal studies. The pathogenesis of MTrPs appears to be related to the integration in the spinal cord (formation of MTrP circuits) in response to the disturbance of the nerve endings and abnormal contractile mechanism at multiple dysfunctional endplates. Methods usually applied to treat MTrPs include stretch, massage, thermotherapy, electrotherapy, laser therapy, MTrP injection, dry needling, and acupuncture. The mechanism of acupuncture is similar to dry needling or MTrP injection. The new technique of MTrP injection can also be used to treat neurogenic spasticity.

肌筋膜疼痛综合征的新趋势。
本文就肌筋膜触发点(MTrP)的研究进展作一综述,以进一步阐明MTrP的作用机制。MTrP是临床上引起肌肉疼痛(肌筋膜疼痛)的主要原因。在一个MTrP区域中存在多个MTrP基因座。MTrP基因座包含感觉成分(敏感基因座)和运动成分(活动基因座)。敏感位点是针刺刺激可引起疼痛、牵涉性疼痛(ReP)和局部抽搐反应(LTR)的部位。根据组织学研究,敏感位点可能是致敏的伤害感受器。它们广泛分布于整个肌肉,但集中在终板区。活性位点是可以记录自发电活动(SEA)的部位。活性位点是功能失调的终板,因为SEA本质上与神经生理学家报道的从异常终板记录的终板噪声(EPN)相同。在人类和动物研究中证实,ReP和ltr都是通过脊髓机制介导的。MTrPs的发病机制似乎与脊髓内的整合(MTrP回路的形成)有关,以响应神经末梢的紊乱和多个功能失调终板的异常收缩机制。通常用于治疗MTrPs的方法包括拉伸、按摩、热疗法、电疗、激光疗法、MTrP注射、干针和针灸。针刺的作用机制类似于干针或MTrP注射。MTrP注射新技术也可用于治疗神经源性痉挛。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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