Rather than viewing MTrPs as the initiating source of nociception, provocative palpation is conceptualized as a fluctuating clinical signal shaped by interacting peripheral, spinal, supraspinal, and contextual influences. Emphasizing pain phenotyping and neurophysiologically guided clinical reasoning over lesion identification may better align myofascial constructs and related interventions, including dry needling, with contemporary pain neurophysiology and support more precise, adaptable clinical management.
Kearns et al. (Fri,) studied this question.