https://chiropracticscience.com/podcast/drjohnsrbely/
https://pubmed.ncbi.nlm.nih.gov/20015704/
https://pubmed.ncbi.nlm.nih.gov/23830709/
My nerdy self has recently discovered a new chiropractic research podcast on which I have been feasting during my long commute, even longer with all the summer road construction season. 1 of the episodes that caught my attention was on myofascial pain syndrome and trigger points. Soft tissue dysfunction has always been of great interest to me, 1 of the reasons for which I incorporated soft tissue therapy in my own clinical practice as well as partner with full-time massage therapist to complement our chiropractic treatment plan in many of our patients.
1 of the great debates within the scientific community is the pathogenesis (a big fancy word for root cause mechanism) of myofascial pain. We have a lot of theories but until recently, when new scientific methods of exploration and data recording have become available, not easily proven by the available research.
The chiropractic clinician being interviewed has been doing full-time research focusing on that area (thanks to our northern Canadian neighbors whose hard earned tax dollars have funded 35 full-time chiropractic research positions in higher education institutions). The idea behind 1 of the studies was to determine if trigger points are inherently the result of peripheral soft tissue insults, such as trauma, chronic mechanical overload, repetitive strain injuries etc., or if there may be more of a central mechanism of trigger point development predisposing to soft tissue in particular areas. This is a question especially relevant for chiropractors, since Empirically we have always found myofascial dysfunction to be jointly occurring with spinal distortion patterns in associated regions.
I'm amazed they were able to recruit volunteers for this particular study because the methodology of inducing trigger points was not particularly pleasant, and those of you who have used hot pepper creams or ever accidentally opened a can of bear spray on yourself can attest how brutally painful capsaicin can be, although innocuous in the long term. The researchers induced chemical irritation using capsaicin at the C5 spinal level, and watched for changes in soft tissue and myofascial sensitivity and tone in the areas associated with the C5 nerve root and dermatome. The study was striking, with extremely high reproducibility of trigger point and other myofascial distortion patterns along segmental distribution of the spinal segment injected. This would indicate that myofascial pain syndrome and trigger point formation is both a peripheral and central problem, meaning that myofascial pain should not be resolved with peripheral soft tissue therapies alone, but will require close attention to any sort of disturbance at the level of the spinal region upstream from the muscle pain, in order to achieve long-term resolution. Something that our profession has certainly empirically practiced for long time, and finally validated with some moderate research.
