Reliability of Physical Examination for Diagnosis of Myofascial Trigger Points

Systematic review: trigger-point palpation is not reliably reproducible

what the source states

A systematic review of examination-reliability studies concluded that manual physical examination for myofascial trigger points has not been demonstrated to be reliable or valid, in part because no accepted reference standard exists, and could not currently be recommended as an objective diagnostic test.

what we infer

The measurement problem underneath everything: studies on both sides of this case locate their object by palpation. Any decisive experiment must first solve blinded, instrumented localization — which is why the keystone study design requires it.

limitations

• Assesses the manual exam, not instrumented detection; imaging-anchored localization may escape the problem.