The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck.
The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck.
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DOI：
10.1007/s11916-007-0219-z
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发表时间：
2007-10-01
影响因子：
3.7
通讯作者：
Pareja, Juan
中科院分区：
文献类型：
--
作者：
Fernandez-de-Las-Penas, Cesar;Simons, David;Pareja, Juan
颈部和头部疼痛综合征是临床实践中常见的问题。通常指定的特发性颈痛和一些原发性头痛（即紧张型头痛或偏头痛）的疼痛特征符合起源于肌肉触发点（TrP）的牵涉痛的描述。本文讨论了支持肌肉TrPs在颈部和头部慢性肌肉骨骼疾病中作用的科学证据。在少数研究中研究了颈部疼痛患者肌肉TrPs引起的牵涉痛的相关性。一些作者发现，颈肩肌肉中的肌肉TrPs和颈关节功能障碍同时有助于颈部疼痛感知。此外，似乎起源于肌肉TrPs的牵涉性疼痛也可能有助于受试者在追尾碰撞后感知到的颈部症状。此外，最近的几项研究报道，TTH和偏头痛都与枕下肌、上斜肌、胸锁乳突肌、颞肌或上级斜肌中的TrP引起的牵涉痛相关。由活性TrPs引起的牵涉性疼痛模仿在这些原发性头痛中头痛发作期间观察到的疼痛区域。根据现有的数据，似乎颈部和头部综合征的疼痛特征可能是由颈后肌、头部和肩部肌肉中的TrP引起的牵涉性疼痛。需要更多的研究来描述肌肉TrPs和头颈部肌肉骨骼疼痛综合征之间关系的更多信息。
Neck and head pain syndromes are common problems seen in clinical practice. Pain features of commonly designated idiopathic neck pain and some primary headaches (ie, tension-type headache or migraine) fit the descriptions of referred pain originating in muscle trigger points (TrPs). This article discusses the scientific evidence supporting the role of muscle TrPs in chronic musculo-skeletal disorders of the neck and head. The relevance of referred pain elicited by muscle TrPs in patients with neck pain has been investigated in few studies. Some authors found that both muscle TrPs in neck-shoulder muscles and cervical joint dysfunctions contribute at the same time to neck pain perception. Furthermore, it seems that referred pain originated in muscle TrPs could also contribute to neck symptoms perceived by subjects after a rear-end crash. In addition, several recent studies reported that both TTH and migraine are associated with referred pain from TrPs in the suboccipital, upper trapezius, sternocleidomastoid, temporalis, or superior oblique muscles. Referred pain elicited by active TrPs mimics the pain areas observed during head pain attacks in these primary headaches. Based on available data, it seems that the pain profile of neck and head syndromes may be provoked referred pain from TrPs in the posterior cervical, head, and shoulder muscles. Additional studies are needed to delineate more information on the relation between muscle TrPs and musculoskeletal pain syndromes of the head and neck.