• The myofascial pain syndromes are characterized by the existence of a hypersensitive region, called the trigger area, in a muscle or in the connective tissue, together with a specific painful reaction elicited in some related target area when the trigger area is stimulated. The more common forms of this syndrome have been mapped anatomically. Physiologically they represent a self-sustaining vicious circle of painspasm-pain. This can be broken at several points by attacking either the motor or the sensory part of the mechanism. Consequently, local anesthesia, physical therapy, corrective exercise, and psychotherapy can all contribute to a cure, and the relief is sometimes dramatic. Two methods for applying local anesthesia are described.
Bonica JJ. MANAGEMENT OF MYOFASCIAL PAIN SYNDROMES IN GENERAL PRACTICE. JAMA. 1957;164(7):732–738. doi:10.1001/jama.1957.02980070014003
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