Criteria used for the diagnosis of myofascial trigger points in clinical trials on physical therapy: updated systematic review

Review written by Ben Cormack info

Key Points

  1. Only 65.1% of trials looking at myofascial trigger points (MTrPs) defined the diagnostic criteria used.
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Musculoskeletal pain is a large contributor to disability in western society with the prevalence estimated to be 56% in people aged 36 to 75 years. Myofascial trigger points (MTrPs) are defined as hyperirritable painful spots in taut bands of skeletal muscle, which are associated with musculoskeletal pain syndromes. MTrP focused research has suggested that MTrPs are a primary cause of pain and a secondary pain generator in many musculoskeletal conditions, although this is not supported by literature outside of MTrP focused research (1).

A gold standard for identifying MTrPs is lacking however, as is research on reliability for their identification. The research that does exist points towards poor reliability and this lack of reliability questions the research that identifies MTrPs as a primary cause of pain. Tough and colleagues (2) conducted a systematic review investigating the criteria adopted by medical researchers to diagnose MTrPs between 1966 and 2006 and found large variation in the diagnostic criteria used and this highlights the need for consensus on diagnostic criteria.

The aim of this systematic review was to build on and update the previous review by Tough et al and bring together diagnostic criteria for MTrPs between 2007 and 2019.

The prevalence of musculoskeletal pain is estimated to be 56% in people aged 36 to 75 years.
For a treatment to be considered effective for a specific condition, the tests used to identify that condition must first have validity and reliability.


This systematic review was registered on the PROSPERO database. A systematic review of relevant peer-reviewed literature published was conducted from January 1, 2007, to April 10, 2019 on MEDLINE and Physiotherapy Evidence Database (PEDro), and involved MeSH keywords: “trigger points,”

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