A patient feels pains which are spontaneous, or cannot be called up by active movements (contractions) of the affected muscle. Pains are rather diffusive, mostly not so much intensive, felt inside the muscles, and have chronic character. They are mostly evoked or worsened by a working overloading and an infection. If there is not any adequate care, the patient gets used to them, and he/she resigns. The patient diagnoses their case as rheumatism!!! The patient feels well except these pains, but a secondary neurotization of the patient can occur.
An extension of the active movement can be lightly restricted due to pains. An extension of the passive movement in the glenohumeral articulation is also restricted at the same extension. Passive elongating of the affected muscle into outer positions is able to evoke an intensive pain14. The restriction of movements is in comparison with the affection at inflammatory affections of the shoulder girdle obvious.
Pains are stronger during an examination of the movement against resistance (isometric contraction).
In the affected muscle there are several points which are painful on the palpation, and when they are touched the pains are called up in the localization identical with resting pain annoying the patient16. The trigger point is mostly spontaneously indolent.
Checking laboratory is always in a norm at these cases, and X-ray, ultrasound examination, MRI, or CT are not able to find the cause of the problems.
14mind! – the active and the passive movement is made in direction of a contraction of the muscle, but the passive elongating is made on the other side
16mind! this painful point is not identical with the place where the pain is felt