Myofascial pain syndromes: where are we? Where are we going?

In recent years, research activity related to myofascial pain syndromes due to trigger points (TrPs) has blossomed. This paper introduces and relates the presentations made in a symposium entitled "Myofascial Pain Syndromes: Where are we? Where are we going?" at the 47th Annual Assembly of the American Academy of Physical Medicine and Rehabilitation in Kansas City October 2, 1985. It summarizes a number of recent research advances and key research issues related to myofascial pain syndromes: 1. Thermography appears valuable for imaging the reflex thermal tracks of previously identified TrPs. 2. Three new devices are reported to measure reliably the pressure threshold for pain of TrPs and tender points (TePs). 3. Fibrositis/fibromyalgia and myofascial pain syndromes may or may not be separate entities. The question needs to be resolved. 4. New evidence strongly supports previous indications that a TrP is a region of increased energy consumption with an inadequate oxygen supply. 5. A foundation has been established for investigating the sensitizing agent(s) responsible for the increased sensitivity of TrPs and muscular TePs. 6. At least four mechanisms can account for the pain referred by TrPs in muscles. The convergence-projection mechanism appears to be consistently present in visceral pain pathways and to be likely in mammalian muscle nociceptive pathways.