Physical Medicine and Rehabilitation for Myofascial Pain Workup

Updated: Mar 15, 2019
  • Author: Jennifer E Finley, MD, FAAPMR; Chief Editor: Dean H Hommer, MD  more...
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Workup

Laboratory Studies

No specific lab tests confirm a diagnosis of myofascial pain (MP), but lab tests can be helpful in looking for predisposing conditions, such as hypothyroidism, hypoglycemia, and vitamin deficiencies. Specific tests that may be helpful include complete blood count (CBC), chemistry profile, erythrocyte sedimentation rate (ESR), and levels of vitamins C, B-1, B-6, B-12, and folic acid. A thyrotropin level may be helpful if clinical features of thyroid disease are present.

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Imaging Studies

Infrared or liquid crystal thermography can show increased blood flow, which is sometimes noted at trigger points. Other imaging studies are useful only to rule out other sources of pain generation. However, a study by Kumbhare et al indicated that ultrasonographic muscle texture analysis can be used to differentiate between healthy trapezius muscles and those affected by myofascial pain. [14]

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Other Tests

Needle electromyography (EMG) examination of trigger points (TrPs) in humans and rabbits has shown high-voltage spike activity and spontaneous, low-voltage endplate noise, which is considered characteristic but not pathognomonic. Surface EMG has been used in experiment protocols to monitor muscle activity in TrPs. Ultrasonography has been used to visualize the LTR elicited by needle penetration.

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Histologic Findings

Contraction knots are a characteristic finding in trigger points, and tender, palpable nodules have been recognized since 1951.

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