Myofascial Pain and Fibromyalgia Syndromes : A Clinical Guide to Diagnosis and Management

by Baldry

• ISBN13: 9780443070037
• ISBN10: 0443070032
• Edition: 1st
• Format: Hardcover
• Copyright: 2001-04-20
• Publisher: CHURCHILL LIVINGSTONE

Summary

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.

Author Biography

Peter E Baldry MB FRCP Emeritus Consultant Physician and Postgraduate Clinical Tutor, Ashford Hospital, London, UK. Muhammad B Yunus MD FACP FACR FRCPE Professor of Medicine, Section of Rheumatology, University of Illinois College of Medicine, Peoria, Illinois, USA Fatma Inanici MD Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey

Table of Contents

Contributors	xi
Foreword	xiii
Preface	xv
Acknowledgements	xvii
PART 1 Myofascial trigger point pain syndromes - pathophysiology and management	1	(118)
The evolution of current concepts	3	(14)
Terminological confusion	3	(4)
John Kellgren's observations	7	(4)
Myofascial trigger point pain syndromes	11	(2)
Fibromyalgia	13	(4)
Relevant neurophysiological mechanisms	17	(28)
Original beliefs	17	(2)
Current concepts	19	(1)
Skin nociceptors	20	(1)
Muscle nociceptors	21	(6)
Transmission of nociceptive information to the brain	27	(1)
Pathways for centripetal transmission of nociceptive information	28	(1)
Brainstem's reticular formation	29	(1)
Pain-modulating mechanisms	30	(3)
Endogenous pain-suppressing substances	33	(2)
Myofascial trigger point pain-suppressing techniques	35	(10)
The emotional aspects of pain	45	(12)
Emotional reactions to pain	45	(2)
Anxiety-induced MTrP pain	47	(1)
Pain-induced behaviour	47	(1)
Assessing the emotional component of organic pain	48	(1)
Psychogenic pain	48	(2)
Trauma-induced MTrP pain erroneously diagnosed as emotional in origin	50	(1)
Psychological effects of compensation-seeking on pain	51	(6)
Myofascial trigger point pain	57	(24)
Morphology of skeletal muscle	58	(1)
Physiological mechanisms involved in voluntary muscle contraction	58	(2)
Pathophysiology of myofascial trigger points	60	(9)
Perpetuation of myofascial trigger point pain	69	(2)
Myofascial trigger point pain referral	71	(1)
The search for myofascial trigger points	72	(1)
Diagnosis of the MTrP pain syndrome	73	(8)
Nociceptive nerve pain, neuropathic pain and myofascial trigger point pain	81	(14)
Pathophysiology of neuropathic pain	81	(3)
Clinical manifestations of pain of neural origin	84	(1)
Some diagnostic pitfalls	85	(2)
Management of pain of neural origin	87	(8)
Concomitant complex regional pain and myofascial trigger point pain syndromes	95	(8)
Terminology	96	(1)
Aetiological factors common to CRPS type 1 (RSD) and the MTrP pain syndrome	96	(1)
Pain-producing mechanisms common to both the MTrP pain syndrome and CRPS type 1 (RSD)	97	(1)
Complex regional pain syndrome type 1 (RSD)	97	(6)
Methods of treating myofascial trigger point pain	103	(16)
Deactivating myofascial trigger points	104	(12)
Clinical trials	116	(3)
PART 2 Regional myofascial trigger point pain syndromes	119	(230)
The neck	121	(30)
Cervical myofascial trigger point pain syndrome	121	(13)
Cervical whiplash injuries	134	(11)
Cervical spondylosis	145	(2)
Cervical disc prolapse	147	(4)
The shoulder	151	(22)
Primary referral of MTrP pain to the shoulder region	151	(13)
Secondary development of MTrP pain	164	(1)
Rotator cuff tendinitis	164	(3)
Associated disorders	167	(1)
Adhesive capsulitis	168	(5)
The arm	173	(28)
Cervical radiculopathic and MTrP brachial pain - differential diagnosis	174	(1)
Brachial pain from TrPs in neck, shoulder girdle and chest wall muscles	174	(1)
Pain from TrPs in the upper arm muscles	175	(3)
Pain from TrPs in the forearm's supinator, brachioradialis and hand extensor muscles	178	(5)
Lateral epicondylitis (syn: tennis elbow)	183	(1)
Pain from TrPs in the forearm's hand and finger flexor muscles	184	(1)
Pain from TrPs in the palmaris longus and pronator teres muscles	185	(3)
Medial epicondylitis	188	(1)
Cubital tunnel syndrome	189	(1)
Carpal tunnel syndrome	190	(1)
Tenosynovitis of the wrist	191	(1)
Pain from MTrPs around the thumb	191	(1)
First carpometacarpal joint osteoarthritis	191	(1)
MTrP pain in the fingers	192	(1)
Osteoarthritic small joints of the hand	193	(1)
Management of the brachial MTrP pain syndrome	193	(1)
Repetitive strain injury	193	(4)
Sympathetically mediated brachial pain	197	(4)
The head and face	201	(26)
Myofascial trigger point cephalalgia	201	(3)
Migraine	204	(8)
Tension-type headaches	212	(2)
Temporo-facial pain	214	(7)
Intra-articular temporomandibular joint pain	221	(1)
Extra-articular temporomandibular pain	222	(5)
The lower back	227	(36)
Lumbar MTrP pain syndrome	229	(13)
Acute, recurrent and chronic lumbar MTrP pain	242	(4)
Lumbar facet joint pain	246	(1)
Lumbar facet joint syndrome	247	(2)
Lumbar disc herniation pain	249	(5)
Lumbar spondylosis	254	(1)
Degenerative spondylolisthesis	255	(1)
Lateral canal stenosis	255	(1)
Neurogenic claudication	256	(7)
The lower limb	263	(40)
Pain from MTrPs in the anterior, lateral and medial aspects of the thigh	264	(5)
Pain from trigger points in the posterior thigh muscles	269	(8)
Pain from MTrPs in the anterior compartment of the leg	277	(4)
Pain from MTrPs in the lateral compartment of the leg	281	(2)
Pain from MTrPs in the superficial posterior compartment of the leg	283	(4)
Pain from MTrPs in the deep posterior compartment of the leg	287	(4)
Pain from MTrPs in the foot	291	(1)
Dorsal surface of the foot	291	(1)
Plantar surface of the foot	292	(5)
Heel and sole of foot pain	297	(6)
The chest wall	303	(26)
Anterior chest wall MTrP pain syndrome	303	(6)
Differential diagnosis	309	(6)
Methods of investigating anterior chest wall pain	315	(2)
Posterior chest wall MTrP pain syndrome	317	(12)
The anterior abdominal wall and pelvic floor	329	(20)
Incidence	330	(1)
Views concerning pathogenesis	330	(1)
Anterior abdominal wall MTrP pain syndrome	331	(7)
Pelvic MTrP pain	338	(11)
PART 3 The fibromyalgia syndrome	349	(50)
Clinical characteristics and biopathophysiological mechanisms of fibromyalgia syndrome	351	(28)
Muhammad B. Yunus
Fatma Inanici
Clinical characteristics	351	(3)
Biopathophysiological mechanisms of FMS	354	(14)
Disability and quality of life in FMS	368	(1)
Central sensitivity syndromes	369	(2)
Summary	371	(8)
Management of fibromyalgia syndrome	379	(20)
Fatma Inanici
Muhammad B. Yunus
Patient education and reassurance	379	(1)
Addressing aggravating factors	380	(2)
Non-pharmacological interventions	382	(3)
Pharmacological management	385	(7)
Tender point injections	392	(1)
Prognosis	393	(1)
Summary	393	(6)
Index	399