Myofascial pain syndrome




Myofascial pain syndrome is chronic condition that causes pain in the musculoskeletal system. 



The pains associated with the syndrome is confined to a particular area. 



It is defined as pain stemming from muscle bands and facia around the muscle. 



Its primary cause is unknown but possibly related to inappropriate release of acetylcholine and starting a cycle of increased metabolism and hypoxia at the muscle band leading to sensitization of the tissue.



Sensitization can activate the autonomic system and potentiate continued acetylcholine released at the local contracture. 



Myofascial pain is associated with triggerpoints, which are hyperirritable localized points of muscular pain. 



Patients present with localization of pain in a taut band of muscle that is alleviated temporarily by massage or stretching.



Patient frequently have an inability to find a comfortable position at rest. 



Trigger points can be a source of referred pain: migraine and tension type headaches, cause pain radiating down extremity and mimicking radiculopathies.



The pain is typically associated with trigger points in muscles. 


These trigger points radiate pain to the affected area when pressure is applied to them, and sometimes spontaneously with no pressure. 


Sometimes this pain can be in what seems to be an unrelated part of the body.



The primary symptoms of myofascial pain syndrome are:



Localized muscle pain



Trigger points that activate the pain



Infrequent but potential symptoms include:



Muscle stiffness






Poor sleep






Myofascial pain syndromes may cause postural abnormalities such as hunching, shoulder rounding, and forward head posture.



No imaging or lab test that can identify myofascial pain syndrome. 



Diagnosis of the syndrome is diagnosed by ruling out other conditions that may be causing the pain.



A physical exam may identify tight muscle bands that trigger the pain or muscle twitches, or postural abnormalities.



Myofascial pain syndrome should not be confused with fibromyalgia, which has similar symptoms, but is a chronic condition that causes pain and tenderness throughout the body.



Fibromyalgia is not localized, and does not include trigger points. 



A patient can have both fibromyalgia and myofascial pain syndrome. 



MFP treatments include:  massage, stretching, physical therapy, and exercise. 



Therapies aim to increase perfusion of the muscles. 



Trigger point injections, dry needling, transcutaneous electrical stimulation and ultrasound therapy can also be used.



Many treatments for myofascial pain syndrome are focused on the trigger points. 



Trigger point treatment options include:



Cold laser (low-level light therapy).



Dry needling



Wet needling (local anesthetic or steroid)



Electrical stimulation









Transcutaneous electrical nerve stimulation






Dietary changes to reduce inflammation and avoid ingredients that seem to trigger pain






Behavior modification 



Physical therapy






Nonsteroidal anti-inflammatory drugs 



Lidocaine patch



Muscle relaxants











Leave a Reply

Your email address will not be published. Required fields are marked *