By Peter Baldry
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Additional resources for Acupuncture, Trigger Points and Musculoskeletal Pain, 3rd Edition
With permission from Virginia P. ) It was Steindler who, during the course of reporting how he was able to relieve ‘sciatica’ by injecting Novocain into tender points in muscles in the lumbar and gluteal regions, first called these points trigger points (TrPs). It was, however, Travell who brought this term into general use when, in the early 1950s, she introduced the adjective myofascial and began to refer to myofascial TrPs and to describe the pain coming from these as myofascial pain. She adopted the term myofascial as a result of observing, whilst doing an infraspinatus muscle biopsy, that the pain pattern evoked by stretching or pinching the fascia enveloping the muscle is similar to that when the same is done to the muscle itself.
Lancet 1: 567–568 Wansborough D 1826 Acupuncturation. Lancet 10: 846–848 Ward T Ogier 1858 On acupuncture. qxd 11*10*04 10:15 Page 31 31 Chapter 4 Some basic observations leading to its development INTRODUCTION CHAPTER CONTENTS Introduction 31 A review of John Kellgren’s laboratory and clinical observations during the 1930s which established that pain which arises from points of maximum tenderness in muscle and certain other structures is referred to distant sites. Also, his injection method of treating this pain 32–35 The relevance of his discoveries to the subsequent development of trigger point acupuncture 36 The traditional practice of Chinese acupuncture having become officially recognized once again in China during the 1950s, and it having since then been increasingly used by some doctors, and to an even greater extent by non-medically qualified practitioners in the West, there are at present many acupuncturists throughout the world who claim it is beneficial in the treatment of a wide variety of disorders.
The search for the source of trouble by defining areas of tenderness is often confused by the patients calling attention to areas of referred tenderness. But referred tenderness is rarely conspicuous, and I have found it a useful guide to consider tenderness to be referred unless the patient winces under the palpation of a given spot. When these acutely tender spots were not too extensive they were infiltrated with 1% Novocain … This infiltration often produced relief of the symptoms and signs, and sometimes abolished them completely.