Tendon and ligament insertions--a possible source of musculoskeletal pain.

In many cases of musculoskeletal pain, the source of the pain is still elusive as indicated by the number of acceptable, but different types of treatments that are available. Within the musculoskeletal system, the tendino-periosteal attachment of the muscles (enthesis) appears to be an area that is especially susceptible to injury as a result of trauma. Because it is a structurally flawed, richly innervated, and metabolically active area, it may be the "weakest link" and most reactive site in the musculoskeletal system. Following episodes of trauma, lesions at the enthesis may result in a wide range of symptoms. Treatment of these lesions may be crucial to the success of post-traumatic pain management.