From The Conclusion…
“To date, the pathogenesis and pathophysiology of MTrPs and their role in MPS remain unknown. Data have been published suggesting that MPS is a pain syndrome that can be acute or chronic, and that it involves muscle and fascia. The MTrP remains central to its diagnosis, and possibly its successful treatment. New methods of describing and imaging the MTrP as well as the milieu of the MTrP have suggested that there are a variety of objective findings associated with the syndrome and active MTrPs.”
“Earlier theories for the pathogenesis of MTrPs and MPS, including muscle overuse and mechanical difficulties, remain current and have been neither proved nor disproved.”
“Many questions remain to be answered. For example, what is the etiology and pathophysiology of MPS? What is the role of the MTrP in the pathogenesis of MPS? Is the resolution of the MTrP required for clinical response? What is the mechanism by which the pain state begins, evolves, and persists? Although the presence of pro-inflammatory and noxious biochemicals has been established, what are the levels of anti-inflammatory substances, analgesic substances, and muscle metabolites in the local biochemical milieu of muscle with and without MTrPs? How does a tender nodule progress to a myofascial pain syndrome? Which musculoskeletal tissues are involved, what are their properties, and how do these change in response to treatment? These are some of the questions that researchers must address in the future. Proper treatment of MPS requires identification and targeting of the mechanisms and pathophysiology of perpetuating factors to obtain sustained relief.”
Shah, J., Thaker, N., Heimur, J., Aredo, J., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. Pm&r, 746-761.