A thorough physical examination and a complete medical history are the two key elements for diagnosis. Physical examination will show the location of trigger points and the local response of the taut muscular band. There are usually no neurological deficits or abnormalities in laboratory tests hematological, biochemical or urinary tract, unless there are concomitant diseases such as nutritional or metabolic disorders. Electromyography will show an increase in spontaneous electrical activity at trigger points. X-rays or MRI reveal no pathological changes in the affected muscle or connective tissue. However, these muscles may show altered patterns of increasing their fatigue, stiffness, subjective weakness, pain on movement and slight decrease in range of motion. Furthermore generate pain when undergoing stretching, forcing the patient to avoid such postures and exercises to maintain muscle contractions greater movement restriction condition. It may be possible to use ultrasound to visualize the spasmodic response by stimulating the trigger point, and thermography, to show areas of increased skin temperature in the region of the trigger points.

The algometers are used to quantify the sensitivity of muscle pressure on one point. Are applied perpendicular to the zone of maximum sensitivity. The pressure threshold is the minimum amount of pressure that induces pain. It is considered abnormal if there is a difference of less than 2 kg cm2-1, involved in a normal control point, usually measured on the opposite side.

To understand the origin of myofascial pain is necessary to understand two concepts: muscle tightness and trigger points (trigger points). Muscle tension is the product of two distinct factors: the tone vis-coelástico and contractile activity. The tone-lastic viscoe can be divided into two parts, the viscoelastic stiffness and elastic stiffness. The elastic stiffness is generated based on the movement, while memory foam is made in terms of speed. Contractile activity consists of three types: contracture, spasm electrogenic (pathological) and stiffness electrogenic. Contracture and electromyographic recording does not originate inside the muscle fibers. Electrogenic spasm is an involuntary muscle contraction caused pathological alpha motor neurons in the motor endplate. Electrogenic Rigidity refers to muscle tension resulting from muscle contraction in individuals who are not relaxed.

The trigger point or “trigger point” is a source of irritability in the muscle when it is deformed by pressure, stretch or contraction, which produces both a point of local pain and referred pain pattern. These trigger points can be classified into:

• Assets: when they are the direct cause of pain.
• Latent: cause dysfunction when performing certain maneuvers but not muscle pain on palpation. They are the most common and can remain dormant for long, becoming active under stress, overuse, stretching, etc.
• Parents: no underlying cause that occurs.
• Children: a nerve entrapment, radiculopathy, and so on.
• Satellites: when the trigger point remains too long without treatment and undertake adjacent structures.

Muscle pain may be associated with trigger points, muscle tension increases or combinations thereof. Myofascial syndrome is defined by the presence of trigger points, while tension headache and temporomandibular joint disorders are associated with them and increased muscle tone.

Another characteristic of myofascial pain is the presence of a palpable muscular band representing a segmental spasm of a small portion of the muscle. This band is not visible but can be appreciated by palpation after exploration of the affected muscle.

Finally, the third component of myofascial pain is referred pain, which has this name because it originates in the trigger point but is perceived distance. Can be confused with radicular pain, but usually does not follow the distribution of a nerve, or displays associated sensory or motor deficits.

The pain is usually constant, deep and dull. Sometimes they may have hyperalgesia and / or Alodia-many resembling paresthesias, requiring differential diagnosis of neuropathic pain.

Patients suffering from myofascial syndrome also accuse symptoms such as sleep disorders and weakness. Autonomic phenomena may also occur in areas of referred pain radiating as vasoconstriction, sweating and pilomotor activity.

Study results published in the Journal of Complementary and Alternative Medicine, suggest that either of the two therapies could benefit those who wish to receive pain relief for chronic skeletal muscle, according to Dr. Peter Dorsher, chronic pain specialist from the Department of Physical Medicine and Rehabilitation at the Mayo Clinic in Jacksonville – Florida.

“This may seem surprising for professional practice another technique, these therapies are unique and are separated by thousands of years,” he said. “However, the study reveals that for the treatment of pain disorders, acupuncture and myofascial techniques are fundamentally similar, which is great news for anyone looking for pain relief.

Traditional Chinese acupuncture treats pain and a variety of health disorders with fine needles to “reset” nerve transmission, explains Dr. Dorsher. The needles are inserted into one or more of the 361 traditional acupuncture points directed to specific organs or pain. “It’s a very safe and effective technique,” he says.

The therapy for myofascial trigger points began to develop from mid-nineteenth century, and is concentrated in areas susceptible muscle or “trigger points”. There are approximately 255 such zones, as described in the Trigger Point Manual (trigger point), original text on myofascial pain.

They think they are painful areas which are composed of muscle and fascia, or network that soft tissue around muscles, bones, organs and other body structures. To relieve pain in trigger points are used, injections, deep pressure, massage, mechanical vibration and electrical stimulation.

Dr. Dorsher analyzed studies published on both techniques and demonstrated that both the acupuncture points and trigger points that are used to treat pain disorders are anatomically and clinically similar.

In a recent study, Dr. Dorsher found that at least 92% of the trigger points correspond to acupuncture anatomy, and in terms of pain, clinical correspondence over 95%. “This means that traditional acupuncture points are located in the same area of the body that trigger points and are used for the same type of problem, in addition to the pattern of referred pain in the trigger point follows the path of the meridian point described by the Chinese acupuncture for over two thousand years, “says Dr. Dorsher.

The myofascial pain therapy has incorporated the use of acupuncture needles in a treatment called “dry needle” to treat trigger points in muscles. “The treatment of myofascial pain is an independently rediscover the healing principles of traditional Chinese medicine,” says Dr. Dorsher. “What possibly links the two disciplines is the nervous system that transmits the pain.”