Contributors | p. xi |
Foreword | p. xiii |
Preface | p. xv |
Acknowledgments | p. xvii |
Myofascial trigger point pain syndromes - pathophysiology and management | p. 1 |
The evolution of current concepts | p. 3 |
Terminological confusion | p. 3 |
John Kellgren's observations | p. 7 |
Myofascial trigger point pain syndromes | p. 11 |
Fibromyalgia | p. 13 |
Relevant neurophysiological mechanisms | p. 17 |
Original beliefs | p. 17 |
Current concepts | p. 19 |
Skin nociceptors | p. 20 |
Muscle nociceptors | p. 21 |
Transmission of nociceptive information to the brain | p. 27 |
Pathways for centripetal transmission of nociceptive information | p. 28 |
Brainstem's reticular formation | p. 29 |
Pain-modulating mechanisms | p. 30 |
Endogeneous pain-suppressing substances | p. 33 |
Myofascial trigger point pain-suppressing techniques | p. 35 |
The emotional aspects of pain | p. 45 |
Emotional reactions to pain | p. 45 |
Anxiety-induced MTrP pain | p. 47 |
Pain-induced behaviour | p. 47 |
Assessing the emotional component of organic pain | p. 48 |
Psychogenic pain | p. 48 |
Trauma-induced MTrP pain erroneously diagnosed as emotional in origin | p. 50 |
Psychological effects of compensation-seeking on pain | p. 51 |
Myofascial trigger point pain | p. 57 |
Morphology of skeletal muscle | p. 58 |
Physiological mechanisms involved in voluntary muscle contraction | p. 58 |
Pathophysiology of myofascial trigger points | p. 60 |
Perpetuation of myofascial trigger point pain | p. 69 |
Myofascial trigger point pain referral | p. 71 |
The search for myofascial trigger points | p. 72 |
Diagnosis of the MTrP pain syndrome | p. 73 |
Nociceptive nerve pain, neuropathic pain and myofascial trigger point pain | p. 81 |
Pathophysiology of neuropathic pain | p. 81 |
Clinical manifestations of pain of neural origin | p. 84 |
Some diagnostic pitfalls | p. 85 |
Management of pain of neural origin | p. 87 |
Concomitant complex regional pain and myofascial trigger point pain syndromes | p. 95 |
Terminology | p. 96 |
Aetiological factors common to CRPS type 1 (RSD) and the MTrP pain syndrome | p. 96 |
Pain-producing mechanisms common to both the MTrP pain syndrome and CRPS type 1 (RSD) | p. 97 |
Complex regional pain syndrome type 1 (RSD) | p. 97 |
Methods of treating myofascial trigger point pain | p. 103 |
Deactivating myofascial trigger points | p. 104 |
Clinical trials | p. 116 |
Regional myofascial trigger point pain syndromes | p. 119 |
The neck | p. 121 |
Cervical myofascial trigger point pain syndrome | p. 121 |
Cervical whiplash injuries | p. 134 |
Cervical spondylosis | p. 145 |
Cervical disc prolapse | p. 147 |
The shoulder | p. 151 |
Primary referral of MTrP pain to the shoulder region | p. 151 |
Secondary development of MTrP pain | p. 164 |
Rotator cuff tendinitis | p. 164 |
Associated disorders | p. 167 |
Adhesive capsulitis | p. 168 |
The arm | p. 173 |
Cervical radiculopathic and MTrP brachial pain - differential diagnosis | p. 174 |
Brachial pain from TrPs in neck, shoulder girdle and chest wall muscles | p. 174 |
Pain from TrPs in the upper arm muscles | p. 175 |
Pain from TrPs in the forearm's supinator, brachioradialis and hand extensor muscles | p. 178 |
Lateral epicondylitis (syn: tennis elbow) | p. 183 |
Pain from TrPs in the forearm's hand and finger flexor muscles | p. 184 |
Pain from TrPs in the palmaris longus and pronator teres muscles | p. 185 |
Medial epicondylitis | p. 188 |
Cubital tunnel syndrome | p. 189 |
Carpal tunnel syndrome | p. 190 |
Tenosynovitis of the wrist | p. 191 |
Pain from MTrPs around the thumb | p. 191 |
First carpometacarpal joint osteoarthritis | p. 191 |
MTrP pain in the fingers | p. 192 |
Osteoarthritic small joints of the hand | p. 193 |
Management of the brachial MTrP pain syndrome | p. 193 |
Repetitive strain injury | p. 193 |
Sympathetically mediated brachial pain | p. 197 |
The head and face | p. 201 |
Myofascial trigger point cephalalgia | p. 201 |
Migraine | p. 204 |
Tension-type headaches | p. 212 |
Temporo-facial pain | p. 214 |
Intra-articular temporomandibular joint pain | p. 221 |
Extra-articular temporomandibular pain | p. 222 |
The lower back | p. 227 |
Lumbar MTrP pain syndrome | p. 229 |
Acute, recurrent and chronic lumbar MTrP pain | p. 242 |
Lumbar facet joint pain | p. 246 |
Lumbar facet joint syndrome | p. 247 |
Lumbar disc herniation pain | p. 249 |
Lumbar spondylosis | p. 254 |
Degenerative spondylolisthesis | p. 255 |
Lateral canal stenosis | p. 255 |
Neurogenic claudication | p. 256 |
The lower limb | p. 263 |
Pain from MTrPs in the anterior, lateral and medial aspects of the thigh | p. 264 |
Pain from trigger points in the posterior thigh muscles | p. 269 |
Pain from MTrPs in the anterior compartment of the leg | p. 277 |
Pain from MTrPs in the lateral compartment of the leg | p. 281 |
Pain from MTrPs in the superficial posterior compartment of the leg | p. 283 |
Pain from MTrPs in the deep posterior compartment of the leg | p. 287 |
Pain from MTrPs in the foot | p. 291 |
Dorsal surface of the foot | p. 291 |
Plantar surface of the foot | p. 292 |
Heel and sole of foot pain | p. 297 |
The chest wall | p. 303 |
Anterior chest wall MTrP pain syndrome | p. 303 |
Differential diagnosis | p. 309 |
Methods of investigating anterior chest wall pain | p. 315 |
Posterior chest wall MTrP pain syndrome | p. 317 |
The anterior abdominal wall and pelvic floor | p. 329 |
Incidence | p. 330 |
Views concerning pathogenesis | p. 330 |
Anterior abdominal wall MTrP pain syndrome | p. 331 |
Pelvic MTrP pain | p. 338 |
The fibromyalgia syndrome | p. 349 |
Clinical characteristics and biopathophysiological mechanisms of fibromyalgia syndrome | p. 351 |
Clinical characteristics | p. 351 |
Biopathophysiological mechanisms of FMS | p. 354 |
Disability and quality of life in FMS | p. 368 |
Central sensitivity syndromes | p. 369 |
Summary | p. 371 |
Management of fibromyalgia syndrome | p. 379 |
Patient education and reassurance | p. 379 |
Addressing aggravating factors | p. 380 |
Non-pharmacological interventions | p. 382 |
Pharmacological management | p. 385 |
Tender point injections | p. 392 |
Prognosis | p. 393 |
Summary | p. 393 |
Index | p. 399 |
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