Chronic Myofascial Pain Diagnostic Criteria

Diagnosis can sometimes be very complicated. The perpetuating factors that cause trigger points can, and do, vary among us. Some of us work at computers, some of us have been in a car accident, some of us are professional athletes, and the list goes on. The thing to remember is that trigger points can be activated by acute overload on the muscle involved, or from chronic overuse of the affected muscle. This can be directly or indirectly due to overwork, over stretching, fatigue, trauma or muscle injury, or by not protecting the muscles from the external environment.

A history of pain resulting from a muscular insult that has outlasted the causative event is the most significant characteristic of chronic myofascial pain disorder. Generally, symptoms that have outlived their usefulness as an alarm system are characterized as chronic. Therefore, diagnostic criteria should include unresolved trigger points that cause specific symptom patterns, predominately pain, for a period longer than should be expected.

It is also important to remember that unlike the tender points of fibromyalgia, trigger points refer pain. The pain or symptom referral pattern for the trigger point involved does not change either in the same patient or between patients.

A clear, concise history is an integral part of the diagnostic criteria. You must help your physician understand the extent of muscle tissue involvement, and how chronic myofascial pain (CMP) interferes with your activity. Once again, an isolated event can cause severe disabling pain and dysfunction, but when successfully treated, it will not lead to a chronic myofascial pain state in the otherwise healthy individual. We are not certain why this is, but a central sensitization phenomenon is suspected.

Like fibromyalgia, the symptoms of chronic myofascial pain can vary from day to day or even hour-by-hour depending upon other perpetuating factors.