Myofascial Trigger Points: Peripheral or Central Phenomenon?

  • César Fernández-de-las-Peñas
  • Jan Dommerholt
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 points Referred pain Sensitization Central Peripheral Myofascial Nociception 


Compliance with Ethics Guidelines

Conflict of Interest

César Fernández-de-las-Peñas and Jan Dommerholt declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • César Fernández-de-las-Peñas
    • 1
    • 2
    • 3
    • 7
  • Jan Dommerholt
    • 4
    • 5
    • 6
  1. 1.Department Physical Therapy, Occupational Therapy, Rehabilitation and Physical MedicineUniversidad Rey Juan CarlosAlcorcónSpain
  2. 2.Esthesiology Laboratory of Universidad Rey Juan CarlosAlcorcónSpain
  3. 3.Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción SecaUniversidad Rey Juan CarlosAlcorcónSpain
  4. 4.Myopain Seminars, LLCBethesda Physiocare, IncBethesdaUSA
  5. 5.Universidad CEU Cardenal HerreraValenciaSpain
  6. 6.Shenandoah UniversityWinchesterUSA
  7. 7.Facultad de Ciencias de la SaludUniversidad Rey Juan CarlosAlcorcónSpain

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