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Highly Accessed Editorial

Fibromyalgia, myofascial pain, tender points and trigger points: splitting or lumping?

Robert M Bennett1* and Don L Goldenberg2

Author Affiliations

1 Fibromyalgia Research Unit, Oregon Health & Science University, 3455 SW Veterans Road, Portland, OR 97239, USA

2 2000 Washington St, Newton, MA 02462, USA

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Arthritis Research & Therapy 2011, 13:117  doi:10.1186/ar3357

Published: 30 June 2011

Abstract

Myofascial trigger points (MTPs) have long been a contentious issue in relation to fibromyalgia, and poorly defined pain complaints in general. Can MTPs be reproducibly identified? Do MTPs have valid objective findings, such as spontaneous electromyographic activity, muscle microdialysis evidence for an inflammatory milieu or visualization with newer ultrasound techniques? Is fibromyalgia a syndrome of multiple MTPs, or is focal muscle tenderness a manifestation of central sensitization? These issues are discussed with relevance to a recent paper reporting that manual palpation of active MTPs elicits the spontaneous pain experienced by fibromyalgia patients.