Current Rheumatology Reports

, 16:395

Myofascial Trigger Points: Peripheral or Central Phenomenon?


    • Department Physical Therapy, Occupational Therapy, Rehabilitation and Physical MedicineUniversidad Rey Juan Carlos
    • Esthesiology Laboratory of Universidad Rey Juan Carlos
    • Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción SecaUniversidad Rey Juan Carlos
    • Facultad de Ciencias de la SaludUniversidad Rey Juan Carlos
  • Jan Dommerholt
    • Myopain Seminars, LLCBethesda Physiocare, Inc
    • Universidad CEU Cardenal Herrera
    • Shenandoah University

DOI: 10.1007/s11926-013-0395-2

Cite this article as:
Fernández-de-las-Peñas, C. & Dommerholt, J. Curr Rheumatol Rep (2014) 16: 395. doi:10.1007/s11926-013-0395-2
Part of the following topical collections:
  1. Topical Collection on Chronic Pain


Trigger points (TrP) are hyperirritable spots in a taut band of a skeletal muscle, which usually have referred pain. There is controversy over whether TrP are a peripheral or central nervous system phenomenon. Referred pain, the most characteristic sign of TrP, is a central phenomenon initiated and activated by peripheral sensitization, whereby the peripheral nociceptive input from the muscle can sensitize dorsal horn neurons that were previously silent. TrP are a peripheral source of nociception, and act as ongoing nociceptive stimuli contributing to pain propagation and widespread pain. Several studies support the hypothesis that TrP can induce central sensitization, and appropriate TrP treatment reduces central sensitization. In contrast, preliminary evidence suggests that central sensitization can also promote TrP activity, although further studies are needed. Proper TrP management may prevent and reverse the development of pain propagation in chronic pain conditions, because inactivation of TrP attenuates central sensitization.


Trigger pointsReferred painSensitizationCentralPeripheralMyofascialNociception

Copyright information

© Springer Science+Business Media New York 2013