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Referred Pain Patterns

Referred Pain Patterns

Pain is a complex symptom experienced differently and individually. However, referred pain is the defining symptom of a myofascial trigger point.

You may be used to the idea of referred pain of visceral origin: an example of this is heart pain. A myocardial infarct (heart attack) is often not experienced as crushing chest pain, but as pain in the left arm and hand, and in the left jaw. This type of pain is well documented, and known to originate from the embryological dermomyotome; in this case, the heart tissue, jaw tissue, and arm tissues all develop from the same dermomyotome.

Referred pain from a myofascial trigger point is somewhat different. It is a distinct and discrete pattern or map of pain. This map is consistent, and has no racial or gender differences, because stimulating an active trigger point generates the pain. 

Patients describe referred pain in this map as having a deep and aching quality; movement may sometimes exacerbate symptoms, making the pain sharper. An example of this might be a headache. The patient often describes a pattern of pain, or ache, which can sometimes be aggravated and made sharper by moving the head and neck. The intensity of pain will vary according to the following factors (this list is not exhaustive):

- Location (attachment points are more sensitive)

- Degree of trigger point irritability

- Active or latent trigger points

- Primary or satellite trigger points

- Site of trigger point (some areas are more sensitive)

- Associated tissue damage

- Location/host tissue stiffness or flexibility

- Ageing

- Chronicity of trigger point


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