Dr. John Srbely discusses myofascial pain and its relationship to nonspecific pain presentations. He explains that myofascial pain involves discomfort in the myofascial tissues and distinguishes it from musculoskeletal pain, which is more acute and involves a breach to the myotendinous unit. Dr. Srbely introduces the concept of neurogenic inflammation and the neurogenic hypothesis of myofascial pain, which suggests that persistent nociceptive bombardment of the dorsal horn leads to sensitization and the release of substance P and CGRP into peripheral tissues. He also discusses the relationship between spinal pathology, such as disc bulges, and neurogenic inflammation. Additionally, Dr. Srbely shares his research on the relationship between osteoarthritis and myofascial pain in the aging population. In this conversation, John Srbely discusses the neurogenic hypothesis of myofascial pain and the role of trigger points. He explains the difference between central and peripheral pain and how pain arising from axial tissues is different from pain arising from peripheral tissues. Srbely also discusses the assessment of peripheral changes and the importance of evaluating the quality of pain. He explores the relationship between densification and trigger points and the potential mechanisms behind trigger point treatment. Additionally, he highlights the comorbidities associated with myofascial pain and the need for standardized terminology and a mechanism-based paradigm.

Chapters

00:00 Introduction and Background

01:44 Understanding Myofascial Pain and Musculoskeletal Pain

04:22 The Role of Neurogenic Inflammation in Myofascial Pain

08:13 The Neurogenic Hypothesis of Myofascial Pain

12:17 The Relationship Between Spinal Pathology and Myofascial Pain

16:19 Identifying the Primary Pathology in Myofascial Pain

34:17 Understanding the Difference Between Central and Peripheral Pain

37:06 Assessing Peripheral Changes and the Importance of Pain Quality

45:26 The Relationship Between Densification and Trigger Points

51:01 Mechanisms Behind Trigger Point Treatment

55:15 Comorbidities Associated with Myofascial Pain

01:03:38 The Need for Standardized Terminology and a Mechanism-Based Paradigm

Melbourne Athletic Development is a sports and injury management clinic based in Melbourne, Australia. To maximise your performance or optimise your injury management contact the team at www.melbourneathleticdevelopment.com.au