The American Medical Association has been recently offering an online Continuing Medical Education course with a four volume text, entitled "Pain Management, Overview of Physiology, Assessment and Treatment (Part 1)," "Assessing and treating Pain in Special Populations (Part 2)," "Management of Persistent Nonmalignant Pain (Part 3)" and "Cancer Pain and End-of-Life Care (Part 4)."
It should be noted that the foreword contains the following statement indicating that the undertreatment of pain is an ethical problem for doctors: The undertreatment of pain has been a deviation from the ethical precept that relieving pain and suffering is one of the principal goals of medicine.
This publication recognizes myofascial pain syndrome as a credible clinical entity:
Myofascial pain syndrome is a condition of mild to severe muscle pain associated with trigger points, the pain is typically localized, often to a single muscle. The syndrome commonly follows "muscle overload," such as may occur or with acute injury… patients complain of a deep, aching pain that is worsened by activity. Postural muscles are often affected. The pain may wax and wane but is usually present always present and can at times be severe.
Trigger points are a diagnostic feature of this syndrome. On physical exam there will be muscle tenderness and limited range of motion and these may be associated with palpable trigger points or "taut bands." Palpating the trigger point produces a local twitch (a visible shortening of the muscle) and referred pain and myofascial pain and most often involves the posterior neck, low back, shoulders, and neck. Chronic pain in the muscles of the posterior neck and referred to muscles in the head can cause persistent headaches; trigger points and lower back muscles can cause referred pain to the leg that mimics sciatica.
Douglas E. Schmidt
Personal Injury Attorney
13911 Ridgedale Drive,
Minneapolis, MN 55305
Phone (952) 473-4530
Toll Free 1-800-656-8450
Fax (952) 544-1308
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