Myofascial Trigger Points: "Death of an Empire"
Our present "Myofascial Pain" caused by "Trigger Points" theory is conjecture and has been thoroughly and quantifiably refuted by science. The following are important pieces of research, links, and discussions in the Manual/Massage Therapy profession, because a significant amount of education was built on the trigger point theory. Moving forward with the current body of science is part of the obligation of regulated healthcare professionals, and
Those pesky scientists have spoiled another theory which I paid a small fortune to learn, and which the current curriculum in Massage Therapy schools still teaches. That’s right; I paid for an education that was obsolete shortly after I graduated. That’s the thing with the field of medicine; it is constantly advancing, changing, and growing. We are learning more and more each day, month, year…and isn’t that a good thing? I think so.
It’s kind of like Star Wars…. Well ok, maybe not, but these are definitely not the trigger points you’re looking for….
"An extensive review identified at least 19 different sets of diagnostic criteria used for the MPS/TrP syndrome, and concluded there was a lack of consistency and consensus on case definition."
"The theory of myofascial pain syndrome (MPS) caused by trigger points (TrPs) seeks to explain the phenomena of muscle pain and tenderness in the absence of evidence for local nociception. Although it lacks external validity, many practitioners have uncritically accepted the diagnosis of MPS and its system of treatment. Furthermore, rheumatologists have implicated TrPs in the pathogenesis of chronic widespread pain (FM syndrome). We have critically examined the evidence for the existence of myofascial TrPs as putative pathological entities and for the vicious cycles that are said to maintain them. We find that both are inventions that have no scientific basis, whether from experimental approaches that inter- rogate the suspect tissue or empirical approaches that assess the outcome of treatments predicated on presumed pathology. Therefore, the theory of MPS caused by TrPs has been refuted. This is not to deny the existence of the clinical phenomena themselves, for which scientifically sound and logically plausible explanations based on known neurophysiological phenomena can be advanced."
"The construct of MPS caused by TrPs remains conjecture. All working hypotheses derived from this conjecture have been refuted and therefore the theory can be discarded. In contrast, evolving insights into the neurobiology of nociception and pain suggest plausible hypotheses that form a basis for advancing knowledge and therapeutics in this challenging area."
Some of my favourite quotes from "A critical evaluation of the trigger point phenomenon" By John L. Quintner, Geoffrey M. Bove, and Milton L. Cohen
Discussion and explanations from the authors HERE and HERE
The wonderful wit of Paul Ingraham’s “Critical evaluation of the trigger point phenomenon” is also really great. "Why do I feel the need to challenge the clinical concept of trigger points? Because the science of trigger points is weak and has yet to produce a proven, reliable way to treat pain. Because many serious, earnest experts have declared their annoyance with dogma and wild speculation about trigger points. Because it’s all a bit half-baked … after decades in the oven."
Thanks for reading, hope you enjoyed the disillusionment!
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