We have conducted a critical appraisal of the literature on myofascial pain syndrome (MPS) with respect to its natural history, epidemiology, etiology, pathophysiology, clinical assessment and treatment. Much of the literature is descriptive and methodologically weak, providing little hard data for physiotherapists. A lack of validated diagnostic criteria has contributed to the confusion between MPS and other chronic pain syndromes. Reported treatments for MPS include stretch and spray, laser, trigger point injections, massage and transcutaneous nerve stimulation. None has been shown to be efficacious. The outcome measures of trigger point tenderness (pressure algometer) and subjective pain (visual analog scale) have been validated in patients, and would be useful in the clinical setting. More research is needed in this area to effectively identify and manage patients.

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