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...o Travell and Simons, '''the most important single aspect''' of myofascial pain management, and the most neglected. ...oke the leg again. ''No one had patched the hole.'' If we treat myofascial pain syndromes without correcting the perpetuating factors that promptly reactiv ...

...d projectile vomiting — is highly distinctive and may not be recognised as myofascial in origin, and because it represents a '''serious postoperative complicatio ...does not primarily produce a referred pain pattern felt by the patient as pain. Instead, its principal effect is '''somatovisceral''': ...

...the anterior rectus sheath, just above the symphysis pubis. Its TrP refers pain close to the midline between the symphysis pubis and the umbilicus. The pyr ==Referred Pain Pattern== ...

...cribed here follows Chapter 5, Section C of Travell & Simons' ''Myofascial Pain and Dysfunction: The Trigger Point Manual''. * Pain on palpation indicates capsular inflammation ...

...ement throughout the length of the thoracolumbar spine produces '''midline pain''' centering on the spinous processes at the segmental level of the TrP, or ==Referred Pain Pattern== ...

...to symptoms of a vascular thoracic outlet syndrome and produce a referred pain pattern extending down the radial side of the arm and forearm to the thumb == Referred Pain Patterns == ...

...rkably independent of body movement and that closely mimics the substernal pain of myocardial infarction or angina pectoris. The muscle is present in appro ...because of their activation as satellite TrPs within the zone of referred pain from the heart. ...

...e posterior cervical spine. Their trigger points (TrPs) produce '''midline pain and tenderness at the segmental level of the TrP''' — a pattern analogous t * [[#Referred Pain Patterns|2 Referred Pain Patterns]] ...

...ency in the developed world. Iron deficiency increases the irritability of myofascial trigger points (TrPs) through multiple mechanisms: it impairs oxygen transp ...n impaired thermoregulation was present in 57% of patients with myofascial pain syndrome, with tissue iron depletion found in 65%. ...

...t is the vitamin most directly linked to the energy crisis at the heart of myofascial trigger point (TrP) pathophysiology. Thiamine insufficiency increases the s Thiamine has been relatively unexplored in relation to myofascial pain syndromes, yet it is considered potentially important because it is essenti ...

...pitis, whose pain encircles the head to the temporal region, multifidi TrP pain is referred '''cephalad to the suboccipital region and caudad toward the sc ...d perpetuate the TrPs, satisfactory management of cervical musculoskeletal pain frequently requires evaluation and treatment of both the muscle TrPs and th ...

...abolism is corrected — patients obtain only temporary relief with specific myofascial therapy, yet recover promptly once thyroid function is adequately supported ...al observation: achieving a TSH of 0.5–2.0 mIU/L in hypothyroid myofascial pain patients can produce spontaneous resolution of TrPs and '''full recovery fr ...

...is''' is a broad, strap-like neck muscle whose trigger points (TrPs) refer pain sharply to the vertex of the skull on the same side. It is one of the most * [[#Referred Pain Patterns|2 Referred Pain Patterns]] ...

...ygoid''' (external pterygoid) is the primary myofascial source of referred pain felt in the TMJ area. Its TrPs are easily mistaken for TMJ arthritis, and t ==Referred Pain Patterns== ...

...rPs in this muscle are commonly overlooked as a myofascial source of chest pain that persists long after myocardial infarction. == Referred Pain Patterns == ...

...ost common vitamin inadequacy''' and among those most likely to perpetuate myofascial trigger points (TrPs). Its metabolism is inseparably intertwined with that ...ravell, Simons, and Gerwin, '''be sure to check your patients with chronic myofascial TrPs for low normal or abnormal serum folate levels.''' ...

...atively narrow posterior cervical muscle whose trigger points (TrPs) refer pain concentrating in the region of the ear or just behind and below it, with po * [[#Referred Pain Patterns|2 Referred Pain Patterns]] ...

...misjudged as visceral in origin. At the S1 level, multifidus TrPs project pain downward to the coccyx and render the coccyx hypersensitive to pressure (re ==Referred Pain Patterns== ...

...r points (TrPs) are active. It is one of the most common sources of facial pain, toothache, tinnitus, and TMJ symptoms, and its TrPs are frequently mistake ==Referred Pain Patterns== ...

...n at the angle of the neck. It is a frequent and underrecognised source of pain in patients following whiplash and in those presenting with "stiff neck." * [[#Referred Pain Patterns|2 Referred Pain Patterns]] ...