Review article (meta-analysis)Prevalence of Myofascial Trigger Points in Spinal Disorders: A Systematic Review and Meta-Analysis
Section snippets
Methods
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines.23 A protocol was written a priori and is available in Appendix 1 Presence of MTrPs in Different Spinal Health Conditions: Protocol for a Systematic Review, Methods Protocol, Appendix 2 Queries for the Bibliographic Databases, Appendix 3 Checklist for Assessing Study Quality, Modified From Downs and Black.
Results
Figure 1 is a flowchart of study retrieval, screening, and eligibility. The 3 experts in the field we contacted did not identify any additional studies besides those retrieved from the database searches and citation tracking. Twelve studies met the eligibility criteria and were included in this review40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51; 4 of these studies40, 42, 44, 49 were included in the meta-analyses. All studies were cross-sectional and assessed the point prevalence of MTrPs. The
Discussion
In this systematic review we aimed to synthesize the evidence on the prevalence of active and latent MTrPs in spinal disorders by including 12 cross-sectional studies assessing point prevalence in 6 different spinal pain disorders. Low-quality evidence was found for the pooled point prevalence of active MTrPs of different muscles in subjects with chronic NP. Point prevalences of active MTrPs in subjects with WAD and NSLBP were extracted from single studies that had low quality and/or very small
Conclusions
This systematic review shows that active and latent MTrPs can be present in different spinal disorders (eg, NP, WAD, NSLBP). However, these findings are at best underpinned by pooled estimates of point prevalence that are based on low-quality evidence, according to the Grading of Recommendations Assessment, Development and Evaluation approach. Most of the estimates for both active and latent MTrPs are based on individual studies with very small sample sizes and low methodologic quality. Future
Suppliers
- a.
EndNote; Thomson Reuters.
- b.
Comprehensive Meta-Analysis 2.0; Biostat.
References (68)
- et al.
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
Lancet
(2013) - et al.
Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
Lancet
(2013) - et al.
The epidemiology of neck pain
Best Pract Res Clin Rheumatol
(2010) - et al.
Cost-of-illness of neck pain in The Netherlands in 1996
Pain
(1999) - et al.
A systematic review of low back pain cost of illness studies in the United States and internationally
Spine J
(2008) - et al.
Regional myofascial pain: diagnosis and management
Best Pract Res Clin Rheumatol
(2007) - et al.
Effectiveness of dry needling on the lower trapezius in patients with mechanical neck pain: a randomized controlled trial
Arch Phys Med Rehabil
(2015) - et al.
Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points
Arch Phys Med Rehabil
(2008) - et al.
Sustained nociceptive mechanical stimulation of latent myofascial trigger point induces central sensitization in healthy subjects
J Pain
(2010) - et al.
Bilateral mechanical-pain sensitivity over the trigeminal region in patients with chronic mechanical neck pain
J Pain
(2010)
Generalized deep-tissue hyperalgesia in patients with chronic low-back pain
Eur J Pain
Latent myofascial trigger points are associated with an increased intramuscular electromyographic activity during synergistic muscle activation
J Pain
Muscle activation patterns in the scapular positioning muscles during loaded scapular plane elevation: the effects of latent myofascial trigger points
Clin Biomech
Myofascial pain syndromes and their evaluation
Best Pract Res Clin Rheumatol
Measures of central hyperexcitability in chronic whiplash associated disorder–a systematic review and meta-analysis
Man Ther
Do various baseline characteristics of transversus abdominis and lumbar multifidus predict clinical outcomes in nonspecific low back pain? A systematic review
Pain
Meta-analysis in clinical trials
Control Clin Trials
GRADE guidelines 6. Rating the quality of evidence–imprecision
J Clin Epidemiol
Myofascial trigger points in the masticatory muscles in patients with and without chronic mechanical neck pain
J Manipulative Physiol Ther
A distinct pattern of myofascial findings in patients after whiplash injury
Arch Phys Med Rehabil
Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study
Man Ther
Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain
J Manipulative Physiol Ther
A systematic, critical review of manual palpation for identifying myofascial trigger points: evidence and clinical significance
Arch Phys Med Rehabil
Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility
Man Ther
Comorbidity negatively influences the outcomes of diagnostic tests for musculoskeletal pain in the orofacial region
Pain
Characteristics of neck and shoulder pain in the Japanese general population
J Orthop Sci
A systematic review of the global prevalence of low back pain
Arthritis Rheum
Comparison of the short-term outcomes between trigger point dry needling and trigger point manual therapy for the management of chronic mechanical neck pain: a randomized clinical trial
J Orthop Sports Phys Ther
Travell & Simons’ myofascial pain and dysfunction: upper half of body
An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle
J Appl Physiol
Chronic whiplash and central sensitization; an evaluation of the role of a myofascial trigger points in pain modulation
J Brachial Plex Peripher Nerve Inj
Evidence of augmented central pain processing in idiopathic chronic low back pain
Arthritis Rheum
Widespread sensory hypersensitivity is a feature of chronic whiplash-associated disorder but not chronic idiopathic neck pain
Clin J Pain
Accelerated muscle fatigability of latent myofascial trigger points in humans
Pain Med
Cited by (0)
Supported by the Thim van der Laan Foundation.
This funding body did not have any role in design, conduction, analysis, and interpretation of data nor in writing this manuscript and deciding to submit this manuscript for publication. The views expressed here are those of the authors and do not necessarily reflect those of their funding bodies.
Disclosures: none.