• Javid Majlesi and Halil Unalan.
• Department of Physical Medicine and Rehabilitation, Cerrahpaşa Faculty of Medicine, Istanbul University, Çatalçeşme Sk, Şükür Apt, Bostancı, Istanbul, Turkey. javidmajlesi@yahoo.co.uk
• Curr Pain Headache Rep. 2010 Oct 1; 14 (5): 353-60.

AbstractPatients with muscle pain complaints commonly are seen by clinicians treating pain, especially pain of musculoskeletal origin. Myofascial trigger points merit special attention because its diagnosis requires examinations skills and its treatment requires specific techniques. If undiagnosed, the patients tend to be overinvestigated and undertreated, leading to chronic pain syndrome. Patients with myofascial pain syndrome present primarily with painful muscle(s) and restricted range of motion of the relevant joint. Palpable painful taut bands are named trigger points and are the main and pathognomonic finding on physical examination. Eliciting local twitch response and referred pain requires experience and examination skills. It may be useful to classify the patient as having acute or chronic, and as having primary or secondary, myofascial pain so the decision on the details of treatment can be curtailed to the needs of each patient. Effective treatment modalities are local heat and cold, stretching exercises, spray-and-stretch, needling, local injection, and high-power pain threshold ultrasound.

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