Inter-therapist reliability in locating latent myofascial trigger points using palpation

SUMMARY. Myofascial trigger points (TPs) are sites in muscle or fascia which are tender to palpate and are located in a taut band of tissue. The significance of TPs is underlined by claims that treatment applied to TPs can be effective in treating pain. Before such claims can be validated, the ability of clinicians to identify these points reliably using palpation needs to be established. The location of such sites is also important for studies which try to determine the relationship of these points to other measures of pathology, e.g. EMG and thermographic abnormalities. Intertester reliability in the localization of these points, therefore, appears to be of primary importance. This study examined the concordance between two experienced clinicians in being able to identify TPs in the upper trapezius muscle. The results indicated that the agreement between these clinicians in identifying TPs in asymptomatic subjects was poor. There was a lack of concordance not only in the location of sites of TPs but also in the numbers of TPs identified. This outcome challenges claims that TPs can be reliably identified using palpation. Copyright 1997 Harcourt Publishers Ltd.