Myofascial Trigger Points In Whiplash Patients

Swiss researchers from the Reha Rheinfelden Rehabilitation Center and the Department of Neurology, University Hospital Basel, have had an article e-published ahead of print in the journal Archives of physical medicine and rehabilitation in which they describe a study that found a distinct pattern of myofascial findings in patients after whiplash injury. [1]

The objective of the study was to identify objective clinical signs for the diagnosis of whiplash syndrome, focusing on myofascial trigger points. Twenty-four healthy controls and 124 patients took part, including 47 patients with whiplash-associated disorders, 21 with Fibromyalgia Syndrome, 17 with nontraumatic chronic cervical syndrome and 15 with endogenous depression. Each participant was manually examined for myofascial trigger points of the semispinalis capitis, trapezius pars descendens, levator scapulae, scalenus medius, sternocleidomastoideus, and masseter muscles bilaterally.

The study found that 40 of the patients with whiplash (85.1%) had myofascial trigger points in the semispinalis capitis muscle, which was a significantly higher prevalence than any of the control groups (P

The researchers concluded that:

"Patients with whiplash showed a distinct pattern of trigger point distribution that differed significantly from other patient groups and healthy subjects. The semispinalis capitis muscle was more frequently affected by trigger points in patients with whiplash, whereas other neck and shoulder muscles and the masseter muscle did not differentiate between patients with whiplash and patients with nontraumatic chronic cervical syndrome or fibromyalgia."

Myofascial pain frequently co-exists with Fibromyalgia Syndrome, but it often unrecognised and left untreated [2]. It is important that Fibromyalgia Syndrome patients are checked out for myofascial problems, especially if they mention localised pain patterns and localised reductions in mobility. The results of this study suggest that it is even more important to check out patients with a whiplash injury for myofascial problems. The study also suggests that examinations for trigger points could be a way of differentiating between whiplash and other conditions that could give similar symptoms.

References:

1. Ettlin T, Schuster C, Stoffel R, Brüderlin A, Kischka U. A Distinct Pattern of Myofascial Findings in Patients After Whiplash Injury. Arch Phys Med Rehabil. 2008 Jun 3. [Epub ahead of print]
2. Starlanyl DJ, Copeland ME. Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual. New Harbinger Publications: 2001.