Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients – Source: Arthritis Research & Therapy, Mar 22, 2011

[Note: to read the full text of this article free in provisional pdf format, click HERE. For more information on myofascial trigger points, see for example Devin Starlanyl’s website.]

Introduction: It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern.

The current study investigated whether the overall spontaneous FM pain pattern can be reproduced by local and referred pain from active MTPs located in different muscles.


• Spontaneous pain pattern in FM was recorded in 30 FM patients and 30 healthy subjects served as controls.

• Local and referred pain patterns induced from active (patients) and latent (controls) MTPs were recorded following manual stimulation.

• The existence of MTPs was confirmed by intramuscular EMG registration of spontaneous electrical activity.


• Local and referred pain areas induced from key active MTPs in FM were larger than pain areas from latent MTPs in healthy controls (P0.05).

• The induced pain area was positively associated with current spontaneous pain intensity in FM (P< 0.01).

• The locations of key active MTPs in FM patients were found to have latent MTPs in healthy subjects.

• The muscles containing key active MTPs in FM are often observed in the muscles of:

Extensor digitorum, trapezius, infraspinatus in the upper part of the body,

– And of quadratus lumborum, gluteus medius in the lower part of the body.


The overall spontaneous FM pain pattern can be reproduced by mechanical stimulation of active Myofascial Trigger Points located in different muscles, suggesting that fibromyalgia pain is largely composed of pain arising from muscle pain and spasm.

Targeting active Myofascial Trigger Points and related perpetuating factors may be an important strategy in FM pain control.

Trial registration: ISRCTN 43167547.

Source: Arthritis Research & Therapy, Mar 22, 2011;13(2). DOI:10.1186/ar3289 (provisional abstract), by Ge H-Y, wang Y, Fernandez-de-las-Penas C, Graven-Nielsen t, Danneskiold-Samsoe B, Arendt-Nielsen L. Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; The Parker Institute, Frederiksberg Hospital, Frederiksberg, Denmark; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain. [Email: Hong-You Ge –]

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