The prevalence of myofascial trigger points in neck and shoulder-related disorders: a systematic review of the literature

BMC Musculoskelet Disord. 2018 Jul 25;19(1):252. doi: 10.1186/s12891-018-2157-9.


Background: Neck and shoulder disorders may be linked to the presence of myofascial trigger points (MTrPs). These disorders can significantly impact a person's activities of daily living and ability to work. MTrPs can be involved with pain sensitization, contributing to acute or chronic neck and shoulder musculoskeletal disorders. The aim of this review was to synthesise evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders.

Methods: We conducted an electronic search in five databases. Five independent reviewers selected observational studies assessing the prevalence of MTrPs (active or latent) in participants with neck or shoulder disorders. Two reviewers assessed risk of bias using a modified Downs and Black checklist. Subject characteristics and prevalence of active and latent MTrPs in relevant muscles was extracted from included studies.

Results: Seven articles studying different conditions met the inclusion criteria. The prevalence of MTrPs was compared and analysed. All studies had low methodologic quality due to small sample sizes, lack of control groups and blinding. Findings revealed that active and latent MTrPs were prevalent throughout all disorders, however, latent MTrPs did not consistently have a higher prevalence compared to healthy controls.

Conclusions: We found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders. Point prevalence estimates of MTrPs were based on a small number of studies with very low sample sizes and with design limitations that increased risk of bias within included studies. Future studies, with low risk of bias and large sample sizes may impact on current evidence.

Keywords: Myofascial pain; Neck pain; Rotator cuff muscle; Shoulder pain; Trigger point.

Publication types

  • Systematic Review

MeSH terms

  • Case-Control Studies
  • Cross-Sectional Studies
  • Humans
  • Myofascial Pain Syndromes / diagnosis
  • Myofascial Pain Syndromes / epidemiology*
  • Neck Pain / diagnosis
  • Neck Pain / epidemiology*
  • Prevalence
  • Shoulder Pain / diagnosis
  • Shoulder Pain / epidemiology*
  • Trigger Points* / pathology