• Robert D Gerwin, Barbara Cagnie, Mirko Petrovic, Jo Van Dorpe, Patrick Calders, and Kayleigh De Meulemeester.
• Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
• Pain Med. 2020 Oct 1; 21 (10): 2348-2356.

ObjectiveThe myofascial trigger point hypothesis postulates that there are small foci of contracted sarcomeres in resting skeletal muscle. Only one example, in canine muscle, has been published previously. This study evaluated human muscle biopsies for foci of contracted sarcomeres.SettingThe Departments of Rehabilitation Sciences and Physiotherapy at Ghent University, Ghent, Belgium.SubjectsBiopsies from 28 women with or without trapezius myalgia were evaluated, 14 in each group.MethodsMuscle biopsies were obtained from regions of taut bands in the trapezius muscle and processed for light and electron microscopy and for histochemical analysis. Examination of the biopsies was blinded as to group.ResultsA small number of foci of segmentally contracted sarcomeres were identified. One fusiform segmental locus involved the entire muscle fiber in tissue from a myalgic subject. Several transition zones from normal to contracted sarcomeres were found in both myalgic and nonmyalgic subjects. The distance between Z-lines in contracted sarcomeres was about 25-45% of the same distance in normal sarcomeres. Z-lines were disrupted and smeared in the contracted sarcomeres.ConclusionsA small number of foci of segmentally contracted sarcomeres were found in relaxed trapezius muscle in human subjects, a confirmation of the only other example of spontaneous segmental contraction of sarcomeres (in a canine muscle specimen), consistent with the hypothesis of trigger point formation and with the presence of trigger point end plate noise.© The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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