The results of a survey published in PAIN Practice confirm the diagnostic problems faced by those suffering Myofascial Pain Syndrome (MPS).
Generally, it can be said that MPS is a chronic pain condition where pressure on sensitive trigger points (“knots”) in one or more muscles of the body causes pain. This pain may not only be present in the muscle, but also in other seemingly unrelated parts of the body, when it is known as “referred pain”. However, MPS has traditionally been under-diagnosed.
The purpose of the survey was to assess the extent of agreement on the signs and symptoms of MPS among physicians, chiropractors, and registered massage therapists. In total, 337 healthcare practitioners participated in the survey which explored agreement with the chosen signs and symptoms using a 7-point agreement scale (1 = absolutely agree, 7 = absolutely disagree).
Agreement was then assessed both within each class of practitioner and across the groups.
The results suggest that both within each group and across the groups there was widespread lack of agreement on the signs and symptoms that define MPS. Not surprisingly, the researchers call for the development of more formal diagnostic criteria:
“We suggest the demonstrated variability in diagnostic knowledge be remedied through the establishment and universal use of official validated criteria. Future research should focus on developing criteria specific to myofascial pain syndrome. Finally, knowledge translation strategies may be implemented to increase clinician knowledge of available criteria.”
This survey follows another recent paper published in the Journal of Back and Musculoskeletal Rehabilitation which investigated the diagnostic criteria for MPS used by physicians in different specialisms, including pain medicine, rheumatology, accident and emergency medicine and general practice. Echoing the survey published in PAIN Practice, the authors of the paper concluded:
“Our findings suggest that the diagnostic criteria are not well known, highlighting the need for an expert consensus to determine the importance of each criterion for MPS diagnosis.”
Clearly, the upshot of such inconsistent use of diagnostic criteria is that many people suffering MPS may either not be receiving appropriate treatment or, possibly worse, may be receiving wholly inappropriate treatment. If left untreated, the condition is likely to deteriorate.
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