Lameness and chronic pain in animals can occur with no identifiable abnormality, or diagnosis, and may persist after all signs of tissue injury have disappeared. Lameness in animals is accepted by veterinarians as being caused by pain.
Failure to identify a pain focus, on standard physical exam and conventional testing methods, is suggestive that MTrPs need to be ruled in/out as the source of pain. Absent/poor teaching of MTrP diagnostic criteria and lack of palpation skills are suggested to be important in the failure to correctly diagnose these syndromes. Training in palpation and observation skills are particularly important. Studies have also found that reliable diagnostic examination for MTrPs requires both training in the diagnostic criteria and clinical experience. Inter-rater reliability studies have recently led to the establishment of some guidelines for diagnostic criteria for MTrPs. Frank (1998) has published the MTrP diagnostic criteria for the dog, but these are equally applicable to any species. MTrPs are only diagnosed from specific historical data and by skilled palpation. No standard laboratory test or imaging technique exists at this point for the diagnosis of myofascial pain syndromes (MPS) due to MTrPs. Subtle alterations of gait due to a primary muscular weakness or fatigue can be observed in veterinary patients. Human patients with muscle pain also present with complaints of weakness or fatigue of the affected muscles. Skeletal muscle pain is difficult to localise as it is typically a referred pain, and may be difficult to differentiate from pain emanating from tendon, joint capsule, or bone. The intensity of the pain may vary from low grade to severe and incapacitating. The pain typically associated with skeletal muscle and its fascia (myofascial pain) is deep, dull and aching, although some variation exists.
The basics of myofascial pain and clinical applications of myofascial trigger point (MTrP) therapy will be discussed. Severe or chronic muscle pain is poorly understood and generally not recognised by standard physical examination and investigative procedures in both human and veterinary patients. Skeletal muscle pain is a common, usually temporary, problem in humans and is often associated with exercise or trauma.
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