By Peter Baldry
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Extra resources for Acupuncture, Trigger Points and Musculoskeletal Pain, 3rd Edition
Kellgren did not confine himself to laboratory experiments but applied knowledge gained from these to clinical medicine. And his paper, A Preliminary Account of Referred Pains Arising from Muscle, published in 1938, is of the greatest possible interest because, unbeknown to him, from his study of a number of cases of what he calls ‘fibrositis’ or ‘myalgia’ he laid down certain principles upon which the practice of modern Western acupuncture is now based. As his observations are therefore of such fundamental importance, part of his paper will be quoted in full: During the last year I have made an extensive investigation of the character and distribution of muscular pain produced experimentally in normal subjects … Briefly I find that pain arising from muscle is always diffuse and is often referred, with a distribution which follows a spinal segmental pattern; and that this referred pain is associated with referred tenderness of the deep structures.
1). She first began to take an interest in it after reading how Edeiken & Wolferth (1936) had been able to reproduce spontaneously occurring shoulder pain by applying pressure to tender points in muscles around the scapula, and then reading about observations made both by Kellgren and by the American orthopaedic surgeon Steindler (1940). 2 David Simons. 1 Janet Travell. (With permission from Virginia P. ) It was Steindler who, during the course of reporting how he was able to relieve ‘sciatica’ by injecting Novocain into tender points in muscles in the lumbar and gluteal regions, first called these points trigger points (TrPs).
Thus, in 1938 and again in 1940, under the name of M Gutstein, he wrote about what he called muscular or common rheumatism. In 1940 under the name of Gutstein-Good he called the disorder idiopathic myalgia. Then, a year later, by which time he had changed his name yet again to Good, he wrote about rheumatic myalgias! In 1950 he called it fibrositis, and in 1951 non-articular rheumatism. To add to the confusion, there was at about the same time an R. R. Gutstein (1955) calling this disorder myodysneuria!