Myofascial trigger points: the current evidence

This paper provides an overview of the current state of knowledge regarding the history, pathophysiology, mechanisms of pain production, and proposed methods of treatment of myofascial trigger points. Despite the increasing body of published literature on this subject, many fundamental questions remain unanswered. This paper aims to give the therapist a greater understanding of the current knowledge of mechanisms of muscle pain, treatments that have been shown to be effective, and the ways in which these treatments may produce their effect. Most effective treatments have at their core a form of counter-stimulation or application of a second noxious stimulus. It remains unclear if it is this counter-stimulation or more specific elements of muscle stimulation that are the active ingredients, but it is possible that each contributes to effective outcomes. q 2003 Elsevier Ltd. All rights reserved.