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Trigger points: an anatomical substratum.

Flávia Emi Akamatsu1, Bernardo Rodrigues Ayres2, Samir Omar Saleh2

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Summary

This study identified specific anatomical locations where the spinal accessory nerve enters the trapezius muscle. These precise locations consistently correlate with myofascial trigger points (MTrPs), aiding diagnosis and treatment.

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Area of Science:

  • Anatomy
  • Neuroscience
  • Physiotherapy

Background:

  • Myofascial trigger points (MTrPs) are associated with specific anatomical locations, but their precise relationship with the innervation of the trapezius muscle is not well-documented.
  • Understanding the anatomical correlations of MTrPs is crucial for effective diagnosis and treatment.

Purpose of the Study:

  • To map the entry points of spinal accessory nerve branches into the trapezius muscle.
  • To identify the anatomical relationship between these nerve entry points and myofascial trigger points (MTrPs).

Main Methods:

  • Detailed dissection of twelve adult cadaver trapezius muscles by anatomy professors and medical graduate students.
  • Stratigraphic dissection to preserve deep motor innervation and identify nerve branching patterns.

Main Results:

  • Identified seven specific points where spinal accessory nerve branches enter the trapezius muscle.
  • Four of these points were consistently identified as motor points and corresponded precisely to clinically described MTrPs in all cadavers.

Conclusions:

  • Established a direct anatomical correlation between spinal accessory nerve branching points and trapezius MTrPs.
  • Provides a scientific basis for understanding MTrP pathophysiology and improving therapeutic interventions for therapists.