Trigger points & tender points: 1 & the same? Does injection treatment help?

Trigger points are defined as areas of muscle that are painful to

palpation and are characterized by the presence of taut bands

and the generation of a referral pattern of pain. Tender

points are areas of tenderness occurring in muscle,

muscle-tendon junction, bursa, or fat pad. When tender points

occur in a widespread manner, they are usually considered

characteristic of fibromyalgia. Trigger points, which

typically occur in a more restricted regional pattern, are

indicative of myofascial pain syndrome. In some patients the

two phenomena may coexists, and overlap syndromes can occur.

Although experienced examiners can generally identify the

same tender points, interrater reliability of trigger points

has been low in most studies. There is continued controversy

regarding the defining characteristics and homogeneity of

myofascial pain because of the variability of the examination

findings. In appropriately selected patients, it appears that

myofascial trigger point injections can be helpful in

decreasing pain and improving range of motion in conjunction

with a comprehensive exercise and rehabilitation program.

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