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Old 03-21-2010, 12:07 AM
freetofu freetofu is offline
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Join Date: Dec 2009
Posts: 18
10 yr Member
freetofu freetofu is offline
Junior Member
 
Join Date: Dec 2009
Posts: 18
10 yr Member
Default article on trigger points and tos

I found a useful 2006 article from The Journal of Manual & Manipulative Therapy titled "Myofascial Trigger Points and Myofascial Pain Syndrome: A Critical Review of Recent Literature." It's a 48-page pdf.

I am unable to include the url, but it's from the Jan Dommerholt page at the Bethesda Physiocare website. UPDATE: I just realized the page is hard to navigate to; try googling bio_dommerholt-addl

It consists of summaries of recent articles along with comments (about 1/2 to 1 page for each article). On pp. E143-E145 it covers a 2005 article titled "Post-traumatic thoracic outlet syndrome (TOS)," by FM Crotti, presenting the results of thoracic outlet surgery for 280 patients. I think readers might be interested in reading the comments:

"Although this paper mentions MTrPs only briefly, the findings have far-reaching consequences for clinical practice and the management of thoracic outlet syndrome. Basically, the authors, who are associated with a neurosurgery clinic, recognized two kinds of pain mechanisms evident in thoracic outlet syndrome. The neurogenic-vascular pain loop is treated successfully with surgery. However, the myofascial pain loop continues after surgery and may be responsible for the poor outcomes frequently reported for thoracic outlet syndrome surgery. Myofascial pain is not necessarily altered by surgery. Ninety percent of patients continued to suffer from myofascial pain following surgery, which prompted the authors to recommend that patients must be informed that the same pain symptoms from before surgery may indeed persist after surgery. Myofascial pain may in fact be the primary problem leading eventually to signs and symptoms of thoracic outlet syndrome3,41. Prior to surgery all patients were seen for at least 3 months in physical therapy. Brachial plexus entrapments are common with MTrPs in the pectoralis minor, and in the anterior and medial scalenes. It is not clear from this paper, to what extend physical therapy included any specific MTrP work, such as manual trigger point release, dry needling, injection therapy, or even postural corrections. The authors observed significant postural deviations, such as a lateral head tilt, an ipsi-lateral pelvic tilt, and scoliosis. These can all be associated with MTrPs in the scalene muscles, paraspinal muscles, and quadratus lumborum for example. The paper does not include the number of patients who did not require surgery after successful physical therapy intervention, leaving the question whether physical therapy and MTrP work can indeed prevent thoracic outlet surgery in a number of patients."

Last edited by freetofu; 03-21-2010 at 03:21 PM.
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