By P.E. Baldry, MB BS FRCP, and John W. Thompson, PhD MB BS FRCP (Auth.)
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Extra resources for Acupuncture, Trigger Points and Musculoskeletal Pain. A scientific approach to acupuncture for use by doctors and physiotherapists in the diagnosis and management of myofascial trigger point pain
He also stated that he thought this neural hyperactivity occurred as a result of external factors such as changes of temperature, alterations in weather conditions, physical exertion and emotional upsets, or, alternatively, because of ‘heightened excitability’ of the nervous system occurring as the result of such influences as heredity, intemperance and illness in general. He was, therefore, beginning to formulate ideas concerning the pathogenesis of muscular rheumatism, which were very much in line with the modern view that the pain develops as a result of nerve endings at tender points (or what today are more often called TrPs) becoming sensitized for one or other of a variety of different reasons.
By 1951, Travell & Rinzler had had sufficient experience in recognizing these patterns of pain referral to enable them to give a detailed description of a large number of them at that year’s meeting of the American Medical Association. In the following year they published an account of them in a classic contribution to the subject, ‘The Myofascial Genesis of Pain’, which is particularly notable for the clarity of its illustrations (Travell & Rinzler 1952). Thirty-one years later, Travell and her colleague David Simons (Fig.
Then, in 1938 there were no less than three important contributions to the subject. qxd 11*10*04 10:15 Page 41 Evolution of knowledge of muscle pain syndromes been considered at some length in Chapter 4. A second was that of the Czechoslovakian physician Reichart, who was one of the first to describe and illustrate diagramatically specific patterns of radiating pains from tender points in muscles. The third came from a Polish physician, Gutstein, following his arrival in England as a political refugee.