Pericranial myofascial tenderness is a common phenomenon in primary headache. Nociception from pericranial muscles may play a role in provoking or aggravating headaches. Conversely, the central mechanisms of headache are also important in myofascial headaches. Myofascial headaches resulting from pericranial musculoskeletal dysfunction may stem from the referred pain caused by central convergence and facilitation. This review comprehensively evaluates myofascial headache in comparison with other primary headaches.
Headache ; Muscles ; Nociception ; Pain, Referred

No abstract available.
Humans ; Pain, Referred ; Stress, Psychological

Based on the modern anatomy and physiology, the referred pain of myofascial trigger points of each muscle is integrated; compared with the twelve meridians as well as conception vessel and governor vessel, the similarity of their position and running course is observed. With the current research progress of myofascial trigger points and fasciology, based on the running course of referred pain of trigger points, combined with fascia mechanics, nerve and vascular, the location of acupoints and meridians, as well as the relationship between acupoints and meridians, are discussed.
Acupuncture Points ; Humans ; Meridians ; Muscles ; Pain, Referred ; Trigger Points

Referred pain is not localized to the site of its cause, but referred to an area that may be an adjacent distant from such a site. With respect to this, there is the possibility of misdiagnosis in the treatment of referred pain patient. We experienced a case of a 31-years-old male patient complaining of right shoulder pain, which subsided after a bursa injection. The patient revisited our clinic after 3 weeks complaining not only of right shoulder pain, but also of right upper quadrant pain and fever. He was diagnosed as having a liver abscess by an imaging study.
Diagnostic Errors ; Fever ; Humans ; Liver Abscess* ; Liver* ; Male ; Pain, Referred ; Shoulder Pain* ; Shoulder*

BACKGROUND: Extracorporeal shock wave therapy (ESWT) is one of the treatment options used for patients with myofascial pain syndrome (MPS), although its effectiveness is controversial. The purpose of this study was to evaluate the effectiveness of ESWT in the treatment of MPS in terms of pain relief and functional improvements. METHODS: We assessed 93 patients with MPS who underwent ESWT from March 2009 to July 2014. After exclusion of 25 patients with shoulder diseases, 68 patients were enrolled in the study. The mean follow-up period was 7.5 months (± 4.2 weeks), and the average duration of symptoms was 5 months (range, 2-16 months). ESWT was applied to intramuscular taut bands and referred pain areas once a week for 3 weeks. Visual analog scale (VAS) pain scores and American Shoulder and Elbow Surgeons (ASES) scores were obtained at an initial assessment and at the 6-week, 3-month, and 6-month follow-up assessments. RESULTS: VAS pain scores and ASES scores improved significantly after 3 sessions of ESWT (p<0.05). Both scores were improved, although not significantly, after 6 weeks (p>0.05). CONCLUSIONS: ESWT is an effective treatment option for patients with MPS.
Elbow ; Follow-Up Studies ; Humans ; Myofascial Pain Syndromes* ; Pain, Referred ; Shock* ; Shoulder ; Visual Analog Scale

PURPOSE: Myofascial pain syndrome (MPS) is thought to be, the least understood and most frequently misdiagnosed disease. With appropriate diagnosis, pain trigger point injection has been proven its effectiveness, so I investigated the usefulness of pain trigger point injection for the treatment of MPS. METHODS: Twelve patients with clinical MPS were evaluated. Pain trigger points were identified by using the positive jump response to the operator's finger pressure. After the pain trigger points had been identified, 2 ml of lidocaine (Travel's technique) were injected. RESULTS: Of the total of 12 patients investigated, include self-diagnosis, 6 (50%) were misdiagnosed mainly as neurosis. These 12 patients had 33 pain trigger points. The pain trigger points were distributed mainly in the chest, 8 patients (66%), and 25 points (76%). As to the duration of pain, in 10 patients, the pain dramatically disappeared within 5 minutes. In the remaining two patients improved symptoms were noted within 20 minutes after injection. CONCLUSIONS: The proper diagnosis of MPS, which is frequently misdiagnosed as neurosis, or some other physiologic and psychologic diseases was the first step and the mainstay in the treatment of MPS. This study suggests that in the diagnosis of MPS, the most practically useful method in the emergency room is to confirm the positive jump response, including tout band and referred pain, by using finger pressure. Pain trigger point injection therapy was dramatically effective, so hopefully it will be available allow clinicians as a possible treatment to better care for patients suffering from MPS.
Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Fingers ; Humans ; Lidocaine ; Myofascial Pain Syndromes ; Pain, Referred ; Thorax ; Trigger Points*

Upper thoracic back pain can be musculoskeletal in origin or it could be visceral referred pain, which may be indicative of a serious medical condition. We experienced a case of a 55-years-old female patient who complained of upper thoracic back pain for 1 month, which started 10 days after a traffic accident. She described the pain as being a dull, constant nagging sensation with an intensity of 4/10 on the visual analogue scale. Her pain did not subside after trigger point injection of the rhomboid and trapezius muscles. She reported intermittent palpitation, which indicated that the cardiovascular or pulmonary systems were involved. She was diagnosed with pulmonary thromboembolism by the imaging studies. Refractory upper thoracic back pain should be investigated to rule out this treatable, but potentially fatal condition.
Accidents, Traffic ; Back Pain* ; Female ; Humans ; Pain, Referred ; Pulmonary Embolism* ; Sensation ; Superficial Back Muscles ; Trigger Points

Upper thoracic back pain can be musculoskeletal in origin or it could be visceral referred pain, which may be indicative of a serious medical condition. We experienced a case of a 55-years-old female patient who complained of upper thoracic back pain for 1 month, which started 10 days after a traffic accident. She described the pain as being a dull, constant nagging sensation with an intensity of 4/10 on the visual analogue scale. Her pain did not subside after trigger point injection of the rhomboid and trapezius muscles. She reported intermittent palpitation, which indicated that the cardiovascular or pulmonary systems were involved. She was diagnosed with pulmonary thromboembolism by the imaging studies. Refractory upper thoracic back pain should be investigated to rule out this treatable, but potentially fatal condition.
Accidents, Traffic ; Back Pain* ; Female ; Humans ; Pain, Referred ; Pulmonary Embolism* ; Sensation ; Superficial Back Muscles ; Trigger Points

Myofascial pain syndrome is defined as the sensory, motor and autonomic symptoms caused by the myofascial trigger points. The sternocleidomastoid muscle is a complex muscle that frequently contains multiple trigger points. These trigger points cause symptoms that are easily misdiagnosed as other conditions. Earache of unexplained origin is likely to be caused by trigger points in the clavicular division of the sternocleidomastiod muscle. The authors report a case of earache caused by a trigger point in the sternocleidomastoid muscle. A 34 year-old woman had earache without any history of trauma or infection. The patient did not have any abnormal finding by otolaryngologic testing, except for an earache, which had not subsided. On physical examination, trigger points in the clavicular division of the sternocleidomastiod muscle were found, and the earache was successfully treated by trigger point injections.
Adult ; Earache* ; Facial Neuralgia ; Female ; Humans ; Myofascial Pain Syndromes ; Pain, Referred ; Physical Examination ; Trigger Points*

The prevalence of lumbar spinal pain rose significantly over 10 years. With respect to clinical management of lumbar spinal pain, the most important things are to understand the definition of terms related to lumbar spinal pain. Despite the efforts of the International Association for the Study of Pain, misuse and confusion still continue among clinicians about the definition of terms related to lumbar spinal pain; back pain, referred pain, radicular pain, radiculopathy, and sciatica. Failure to distinguish one type of lumbar spinal pain from the others may lead to unnecessary tests, misdiagnosis, and mismanagement such as an unnecessary surgery. This confusion also exists in developing animal models of lumbar spinal pain by basic scientists. Thus, the exact understandings of definition and physiology of terms related to lumbar spinal pain are essential to manage patients and research the lumbar spinal pain properly.
Back Pain ; Diagnostic Errors ; Humans ; Models, Animal ; Pain, Referred ; Prevalence ; Radiculopathy ; Sciatica ; Unnecessary Procedures