By Peter Baldry
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Extra resources for Acupuncture, Trigger Points and Musculoskeletal Pain, 3rd Edition
American Journal of Surgery 3: 523–533 Baldry P E 1971 The battle against heart disease. University Press, Cambridge Balfour 1815 Observations on the pathology and cure of rheumatism. Edinburgh Medical and Surgical Journal 11: 168–187 Balfour 1816 Observations with cases illustrative of new simple and expeditious mode of curing rheumatism and sprains. … Adam Black, Edinburgh Balfour 1824a Illustrations of the efficacy of compression and percussion in the cure of rheumatism and sprains. The London Medical and Physical Journal 51: 446–462 Balfour 1824b Illustrations of the efficacy of compression and percussion in the cure of rheumatism and sprains.
3. qxd 11*10*04 10:15 Page 33 Some basic observations leading to its development Kellgren also points out in this paper that an injection of saline into muscle produces pain at some distance from the point stimulated and that, in certain cases, the maximal pain is not experienced in muscle itself but in other structures. From his experimental work he was able to show, for example, that when an injection is given into the occipital muscle, pain is felt diffusely as a headache; when into the masseter muscle, it is felt in the mouth as toothache; when into the infraspinatus muscle, it is felt at the tip of the shoulder; when into the vastus intermedius, it is felt around the knee joint; when into the peroneus longus, it is felt at the ankle joint; and when into the multifidus muscle opposite the first and second lumbar vertebrae, it is felt in the scrotum.
However, it soon became apparent that not only are nodules not always present in the disorder, but also they can occasionally be present in people with no history of it. It is because of their somewhat enigmatic and elusive nature, and because of their distinctly nebulous morphology (Ch. 7), that over the course of this century their diagnostic significance has increasingly come to be questioned. Despite this, there is no doubt that when nodules are specifically sought they are frequently found in the lumbar region in patients with chronic low-back pain, and also, though less frequently, in the neck and shoulder girdle of those affected by persistent musculoskeletal pain at that site.