Myofascial pain syndrome, also known as chronic myofascial pain, is a syndrome characterized
by chronic pain caused by multiple trigger points and fascial constrictions. Characteristic
features of a myofascial trigger point include: focal point tenderness, reproduction of pain
upon trigger point palpation, hardening of the muscle upon trigger point palpation, pseudo-weakness
of the involved muscle, referred pain, and limited range of motion following approximately
5 seconds of sustained trigger point pressure.
Symptoms Myofascial pain can occur in distinct, isolated
areas of the body, and because any muscle or fascia may be affected, this may cause
a variety of localized symptoms. More generally speaking, the muscular pain is steady, aching,
and deep. Depending on the case and location the intensity can range from mild discomfort
to excruciating and "lightning-like". Knots may be visible or felt beneath the skin. The
pain does not resolve on its own, even after typical first-aid self-care such as ice, heat,
and rest. MPS and fibromyalgia
MPS and fibromyalgia share some common symptoms, such as hyperirritability, but the two conditions
are distinct. However, a patient may suffer from MPS and fibromyalgia at the same time.
In fibromyalgia, chronic pain and hyperirritability are pervasive. By contrast, while MPS pain
may affect many parts of the body, it is still limited to trigger points and hot spots of
referred pain. Causes
The precise causes of MPS are not fully documented or understood. Some systemic diseases, such
as connective tissue disease, can cause MPS. Poor posture and emotional disturbance might
also instigate or contribute to MPS. Treatment
Massage therapy using trigger-point release techniques may be effective in short-term
pain relief. Physical therapy involving gentle stretching and exercise is useful for recovering
full range of motion and motor coordination. Once the trigger points are gone, muscle strengthening
exercise can begin, supporting long-term health of the local muscle system.
Three types of drugs are used to treat myofascial pain: anti-depressants, anticonvulsants such
as pregabalin, and muscle relaxants such as Baclofen.
Myofascial release, which involves gentle fascia manipulation and massage, may improve
or remediate the condition. A systematic review concluded that dry needling
for the treatment of myofascial pain syndrome in the lower back appeared to be a useful
adjunct to standard therapies, but that clear recommendations could not be made because
the published studies were small and of low quality.
Trigger point injections using local anaesthetic such as Lidocaine is a controversial treatment
with many anaesthetists not willing to perform them due to their belief of the technique
being unable to provide relief or due to little knowledge of myofascial pain syndrome and
how to perform TPIs. The treatment has been found effective in regard to patients finding
longer term relief after a few sessions or regular TPIs providing relief from pain substantial
to reduce the use of severe pain medications like Oxycodone or Tramadol.
Posture evaluation and ergonomics may provide significant relief in the early stages of
treatment. Movement therapies such as Alexander Technique and Feldenkrais Method may also
be helpful. See also
Wise-Anderson Protocol a specialized protocol for treating myofascial pelvic pain
References
Sources Starlanyl, Devin J.; Copeland, Mary Ellen.
Fibromyalgia & Chronic Myofascial Pain: A Survival Manual. Oakland, CA: New Harbinger
Publications. ISBN 978-1-57224-238-8. External links
Fibromyalgia and Chronic Myofascial Pain