Clinical implication of latent myofascial trigger point.

Myofascial trigger points (MTrPs) are hyperirritable points located within a taut band of skeletal muscle or fascia, which create referred pain, local tenderness and autonomic changes when compressed. There are essential differences between the effects created by the two basic types of MTrPs (active and latent). Active trigger points (ATrPs) usually produce referred pain and tenderness. On the other hand, latent trigger points (LTrPs) are foci of hyperirritability in a taut band of muscle, which are clinically connected with a local twitch response, tenderness and/or referred pain upon manual examination. LTrPs may be found in many pain-free skeletal muscles and may be “activated” and converted to ATrPs by continuous detrimental stimuli. ATrPs can be inactivated by different treatment strategies; although, they do not completely disappear but instead are change to the latent form. Therefore, the diagnosis and treatment of LTrPs is important. The authors composed this review to highlight the clinical implication of LTrPs.

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Celeste Cooper

I might add, that sometimes a latent TrP is the primary TrP, and the active TrP is secondary or satellite. When only treating the one that screams out ( the active TrP) without tracing the referral pattern back to the primary TrP, relief will be limited, and it will seem to the patient that the treatment doesn’t work. Treating primary TrPs even when latent is paramount to success.

We don’t know why treating comorbid MPS in FM does not sustain relief. This is why they are a great peripheral pain generator. When they co-occur, I suspect the FM wind-up phenomenon is involved.

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