Clinicians' perspective of the current diagnostic criteria for myofascial pain syndrome

Article type: Research Article

Authors: Grosman-Rimon, Liza^{a; b; d} | Clarke, Hance^{c; d} | Chan, Aaron K.^{e; f} | Mills, Patricia Branco^{e; f} | Rathbone, Alasdair Timothy Llewelyn^g | Kumbhare, Dinesh^{a; b; d; *}

Affiliations: [a] Toronto Rehabilitation Institute, Toronto, ON, Canada | [b] University Health Network, Toronto, ON, Canada | [c] Toronto General Hospital, Toronto, ON, Canada | [d] University of Toronto, Toronto, ON, Canada | [e] University of British Columbia, Vancouver, BC, Canada | [f] GF Strong Rehabilitation Centre, Vancouver, BC, Canada | [g] Western University, London, ON, Canada

Correspondence: [*] Corresponding author: Dinesh Kumbhare, 550 University Avenue, Suite 7-144, Toronto, ONT, M5G 2A2 Canada. Tel.: +1 416 597 3422; E-mail:dinesh.kumbhare@uhn.ca

Abstract: INTRODUCTION: Myofascial pain syndrome (MPS) is one of the most common chronic musculoskeletal pain disorders. However, MPS is often under-diagnosed. The purpose of this study was to characterize practicing clinicians' perspectives of the current diagnostic criteria for MPS. METHODS: A cross-sectional study design was used with a self-administered questionnaire. The questionnaire evaluated clinicians' perspective of the current diagnostic criteria for MPS. The sample population (n= 119) consisted of 40% family physicians, 31% physical medicine (PM) and rehabilitation specialists, 11% rheumatologists, 10% emergency room (ER) physicians, and 8% anesthesiologists specializing in chronic pain. RESULTS: Our findings demonstrated that participating clinicians agree that ``point tenderness'' and ``pain reproduction'' are criteria for MPS. In contrast, the clinicians do not consider ``autonomic symptoms'' as an important criterion for MPS. The anesthesiologists view ``restricted range of motion'' as a criterion for MPS more than the other groups, and they tend to consider ``referred pain'' and ``pain reproduction'' as criteria. Physical medicine and rehabilitation specialists and anesthesiologists tend to view ``local twitch response'' more as a criterion for MPS compared with the other groups. Most groups of clinicians consider ``weakness without atrophy'' as an important MPS criterion except for family physicians. It is important to note that ``poor sleep'', ``daytime fatigue'' and ``cognitive symptoms'', which are not considered as MPS symptoms, are often mistaken for MPS among practicing clinicians. CONCLUSION: Our findings suggest that the diagnostic criteria are not well known, highlighting the need for an expert consensus to determine the importance of each criterion for MPS diagnosis.

Keywords: Myofascial pain syndrome, questionnaire, MPS diagnosis

DOI: 10.3233/BMR-150380

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 509-514, 2017