Disturbances of Pain Perception in Myofascial Pain Syndrome and other Musculoskeletal Pains

Abstract

Pains from the musculoskeletal system represent a major proportion of complaints among patients seeking health services. Moreover, the efficacy of treatment of many musculoskeletal pain conditions by currently available pharmacologic and nonpharmacologic interventions is often less than optimal (Curatolo and Bogduk, 2001). Thus, it is generally accepted that pain from deep tissues constitutes a special diagnostic and therapeutic challenge, and further insights into the peripheral and central neurobiological mechanisms are necessary to improve diagnosis and management strategies. This chapter will mainly focus on the so-called myofascial pain syndrome (MPS). An unrefined search in PubMed reveals more than 4000 publications with the keyword "myofascial pain syndrome" and several extensive reviews and books are available on this topic (Fricton and Awad, 1990; Vaeroy and Merskey, 1993; Simons et al., 1999; Mense and Simons, 2001; Rivner, 2001; Borg-Stein and Simons, 2002). However, this chapter will attempt to critically review some of the proposed pain mechanisms and most prominent clinical presentations of MPS. In addition, the utility of quantitative sensory testing in assessment of muscle pain conditions will be discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)