ABSTRACT
The myofascial pain syndrome has long been a clinical subject of interest as well as a diagnostic problem and dilemma. Historically, there have been many names for this clinical entity, which has led to a great deal of confusion. The older names included myofibrositis, myofascitis, fibromyositis, myogelosis, and fibrositis, to name a few. Flat palpation is the best way to begin, particularly, in large and smaller muscles that can be palpated from only one side. The fingers are slightly bent, with the fingertips perpendicular to the palm. Low back pain may be secondary to the lower aspects of the rectus abdominis muscles as well as the thoracolumbar paraspinal muscles. The piriformis muscle may also induce sciatic pain that may be assumed to be secondary to a herniated lumbar disk. Primary adrenal insufficiency, or Addison’s disease, may present with muscle pain, spasm or, on occasion, knee contractures.
