The DOI matches its Crossref record; 66 of the 66 references it cites were found in a registry or an index.
Reliability of Physical Examination for Diagnosis of Myofascial Trigger Points: A Systematic Review of the Literature
Abstract
BACKGROUND: Trigger points are promoted as an important cause of musculoskeletal pain. There is no accepted reference standard for the diagnosis of trigger points, and data on the reliability of physical examination for trigger points are conflicting. OBJECTIVES: To systematically review the literature on the reliability of physical examination for the diagnosis of trigger points. METHODS: MEDLINE, EMBASE, and other sources were searched for articles reporting the reliability of physical examination for trigger points. Included studies were evaluated for their quality and applicability, and reliability estimates were extracted and reported. RESULTS: Nine studies were eligible for inclusion. None satisfied all quality and applicability criteria. No study specifically reported reliability for the identification of the location of active trigger points in the muscles of symptomatic participants. Reliability estimates varied widely for each diagnostic sign, for each muscle, and across each study. Reliability estimates were generally higher for subjective signs such as tenderness (kappa range, 0.22-1.0) and pain reproduction (kappa range, 0.57-1.00), and lower for objective signs such as the taut band (kappa range, -0.08-0.75) and local twitch response (kappa range, -0.05-0.57). CONCLUSIONS: No study to date has reported the reliability of trigger point diagnosis according to the currently proposed criteria. On the basis of the limited number of studies available, and significant problems with their design, reporting, statistical integrity, and clinical applicability, physical examination cannot currently be recommended as a reliable test for the diagnosis of trigger points. The reliability of trigger point diagnosis needs to be further investigated with studies of high quality that use current diagnostic criteria in clinically relevant patients.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The Measurement of Observer Agreement for Categorical Data
Landis, J. R., & Koch, G. G. (1977) · Biometrics · doi:10.2307/2529310 · Cited by 81,148
Whiting, P., Rutjes, A. W., Reitsma, J. B., Bossuyt, P. M., & Kleijnen, J. (2003) · BMC Medical Research Methodology · doi:10.1186/1471-2288-3-25 · Cited by 3,592
Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD Initiative.
Bossuyt, P. M., Reitsma, J. B., Bruns, D. E., Gatsonis, C. A., Glasziou, P. P., Irwig, L. M., Lijmer, J. G., Moher, D., Rennie, D., de Vet, H. C. W., et al. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-138-1-200301070-00010 · Cited by 3,219
Self-citationTowards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative
Bossuyt, P. M., Reitsma, J. B., Bruns, D. E., Gatsonis, C. A., Glasziou, P. P., Irwig, L. M., Lijmer, J. G., Moher, D., Rennie, D., & de Vet, H. C. W. (2003) · BMJ · doi:10.1136/bmj.326.7379.41 · Cited by 3,215
Self-citationTowards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD Initiative
Bossuyt, P. M., Reitsma, J. B., Bruns, D. E., Gatsonis, C. A., Glasziou, P. P., Irwig, L. M., Lijmer, J. G., Moher, D., Rennie, D., & de Vet, H. C. W. (2003) · Radiology · doi:10.1148/radiol.2261021292 · Cited by 3,215
Self-citationChronic pain in Australia: a prevalence study.
Blyth, F. M., March, L. M., Brnabic, A. J. M., Jorm, L. R., Williamson, M., & Cousins, M. J. (2001) · Pain · doi:10.1016/s0304-3959(00)00355-9 · Cited by 1,096
Shah, J. P., Danoff, J. V., Desai, M. J., Parikh, S., Nakamura, L. Y., Phillips, T. M., & Gerber, L. H. (2008) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2007.10.018 · Cited by 758
Interrater reliability in myofascial trigger point examination
Gerwin, R. D., Shannon, S., Hong, C.-Z., Hubbard, D., & Gevirtz, R. (1997) · Pain · doi:10.1016/s0304-3959(96)03248-4 · Cited by 691
Côté, P., Cassidy, D. J., Carroll, L. J., & Kristman, V. (2004) · Pain · doi:10.1016/j.pain.2004.09.004 · Cited by 624
Travell & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual
Simons, D. G., Travell, J. G., & Simons, L. S. (1999) · Medical Entomology and Zoology · Cited by 584
Cited by
Bo, K., Frawley, H. C., Haylen, B. T., Abramov, Y., Almeida, F. G., Berghmans, B., Bortolini, M., Dumoulin, C., Gomes, M., McClurg, D., et al. (2017) · International Urogynecology Journal · doi:10.1007/s00192-016-3123-4 · Cited by 429
Fernández-de-las-Peñas, C., & Dommerholt, J. (2018) · Pain Medicine · doi:10.1093/pm/pnx207 · Cited by 336
Doggweiler, R., Whitmore, K. E., Meijlink, J. M., Drake, M. J., Frawley, H., Nordling, J., Hanno, P., Fraser, M. O., Homma, Y., Garrido, G., et al. (2017) · Neurourology and Urodynamics · doi:10.1002/nau.23072 · Cited by 230
Llamas-Ramos, R., Pecos-Martín, D., Gallego-Izquierdo, T., Llamas-Ramos, I., Plaza-Manzano, G., Ortega-Santiago, R., Cleland, J., & Fernández-de-las-Peñas, C. (2014) · Journal of Orthopaedic & Sports Physical Therapy · doi:10.2519/jospt.2014.5229 · Cited by 185
Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2014) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2013.11.004 · Cited by 153
Metadata
- Authors
- Lucas, N., Macaskill, P., Irwig, L., Moran, R., & Bogduk, N.
- Venue
- The Clinical Journal of Pain
- Published
- 2009-01
- Volume
- 25
- Issue
- 1
- Pages
- 80-89
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2028002525
- Cited by
- 295
- References
- 66
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- closed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Reliability of Physical Examination for Diagnosis of Myofascial Trigger Points: A Systematic Review of the Literature. https://app.cochat.ai/papers/10.1097/ajp.0b013e31817e13b6
- The paper
- Lucas, N., Macaskill, P., Irwig, L., Moran, R., & Bogduk, N. (2009). Reliability of Physical Examination for Diagnosis of Myofascial Trigger Points: A Systematic Review of the Literature. The Clinical Journal of Pain. https://doi.org/10.1097/ajp.0b013e31817e13b6
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
