What Is Myofascial Pain Syndrome?
Myofascial pain syndrome (MPS) is a chronic pain disorder that affects the fascia (the connective tissue that covers the muscles) and causes inflammation. MPS may affect a single muscle or a muscle group. In some cases, the area where a person has the pain may not be where the myofascial pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This is known as referred pain.
Myofascial pain syndrome vs. fibromyalgia
Both myofascial pain syndrome and fibromyalgia are chronic pain disorders. But there are distinctions between the two. A correct diagnosis is vital for you to receive the best treatment.
Neither myofascial pain syndrome nor fibromyalgia has specific tests for diagnosis. Instead, your doctor can give a clinical diagnosis based on symptoms, a physical examination, and ruling out other possible diagnoses.
What Causes Myofascial Pain?
Myofascial pain (MFP) may come from a muscle injury or from heavy strain on a particular muscle or muscle group, ligament, or tendon. Other causes include:
- Injury to muscle fibers
- Repetitive motions
- Lack of activity (such as having a broken arm in a sling)
Myofascial Pain Syndrome Symptoms
Symptoms of myofascial pain syndrome include:
- Localized point of pain that is tender to the touch
- Muscle pain from pressure on a trigger point
- Referred pain
- Pain that feels like burning, aching, stinging, or stabbing
- Pain that worsens with activity or stress
- Reduced mobility or weakness in the area of pain
Symptoms caused by chronic pain from MPS include depression, sleep disturbances, headaches, and fatigue.
Types of myofascial trigger points
Trigger points are localized, very tender areas of pain within the fascia band of a skeletal muscle. The following are types of trigger points:
Active trigger point
Active trigger points are painful at rest. The referred area of pain from an active trigger point may be tender to touch. Pain between the trigger point and the referred area may feel like it's radiating out along the same muscle.
Latent trigger point
Latent trigger points are not painful at rest. Instead, they restrict movement and cause weakness. Latent trigger points only feel tender when pressure is put on the area.
Satellite trigger point
Satellite trigger points are the domino effect of myofascial pain. Originating from an active trigger point, the satellite trigger point causes pain within the referred area.
How Is Myofascial Pain Diagnosed?
Trigger points can be identified by pain that results when pressure is applied to a specific area of a person's body. In the diagnosis of myofascial pain syndrome, two types of trigger points can be distinguished:
- An active trigger point is an area of extreme tenderness that usually lies within the skeletal muscle and which is linked to local or regional pain.
- A latent trigger point is a dormant (inactive) area that has the potential to act like a trigger point. It may restrict movement or cause muscle weakness.
Myofascial Pain Risk Factors
Myofascial pain can stem from various things. Common risk factors are repetitive overuse of the muscles, an acute injury that didn’t heal, structural issues, and stress.
Chronic issues such as scoliosis, spondylosis, osteoarthritis, and osteoporosis can negatively affect your posture. An imbalanced posture can create muscular knots and trigger points. Over time, if unaddressed, you can get MFP.
Other factors and nutritional imbalances can also increase your risk of MFP. Have your doctor check for hypothyroidism – a condition when your thyroid doesn't make enough hormones for your body – or a vitamin D or iron deficiency. Treating these imbalances may reduce your risk of getting MFP.
Stress and anxiety may also increase your risk of MFP. Stress can cause some people to clench their muscles subconsciously. Repetitive muscle tension is often localized to the same area, leading to trigger points.
Myofascial Pain Complications
If myofascial pain isn't treated, more complications can arise, such as:
Sleep disturbance
Chronic pain can make you less able to sleep well at night. Long-term sleep disturbances can set off a cascade of other problems, like fatigue, memory loss, and mood disorders.
Fibromyalgia
Fibromyalgia causes chronic pain affecting the muscles and joints throughout the body. Some doctors believe it can come from localized MFP, then later become widespread fibromyalgia.
Mental health issues
On average, 35% to 45% of people who struggle with chronic pain get mental health conditions. Disruptions in daily tasks and lifestyle from pain can lead to depression, anxiety, and substance abuse.
Migraine and tension headaches
Active trigger points can create headaches and migraines in referred pain areas.
Myofascial Pain Syndrome Treatment
Myofascial pain medication
Nonsteroidal anti-inflammatories are often used to reduce pain and inflammation caused by myofascial pain. Mild opioids also have been used. But they should be used with caution, as research shows they can set back recovery. Muscle relaxants are sometimes used, as well as medications for sleep or depression.
Nonsteroidal anti-inflammatory medications:
- Diclofenac
- Ibuprofen
- Naproxen
- Acetaminophen
Antidepressants:
- Tricyclic antidepressants
- Duloxetine
- Sumatriptan
Muscle relaxants:
- Tizanidine
- Benzodiazepines (also antidepressant)
- Cyclobenzaprine
- Thiocolchicoside (also anti-inflammatory)
Myofascial pain therapy
Nondrug treatments can ease myofascial pain and are often necessary to correct structural imbalances causing myofascial pain. They include:
- Physical therapy
- Myofascial release therapy
- "Stretch and spray" technique, which involves spraying the muscle and trigger point with a coolant and then slowly stretching the muscle
- Massage therapy
- Trigger point injection
- Ultrasound therapy
In some chronic cases of myofascial pain, combinations of medication, physical therapy, myofascial release therapy, trigger point injections, or massage are needed.
Myofascial pain home remedies
- Reduce and manage stress levels
- Develop healthy sleep habits
- Eat a healthy diet
- Reduce alcohol, which can increase inflammation in the body
- Gentle exercise and stretching
Myofascial Pain Prevention
Myofascial pain syndrome can be prevented by addressing any ongoing pain right away. Your doctor should examine any pain lasting more than a few days. They may prescribe physical therapy if there is an injury or chronic condition.
If your daily tasks or work requires repetitive motions, taking precautions can help prevent MFP. Regular breaks to rest, walk, stretch, or move in an opposing direction help.
Consistent daily habits, including good sleep hygiene, a healthy diet, regular exercise, stress reduction and hydration, can all help cut your chances of getting myofascial pain syndrome.
Myofascial Pain Prognosis
The outcome of your myofascial pain syndrome depends on whether the pain is acute or chronic, how quickly the pain is addressed, and if treatment is given.
Acute myofascial pain syndrome gets better faster than chronic myofascial pain syndrome when addressed with treatment right away. Chronic myofascial pain syndrome may return if there are other health issues that have not been addressed.
The average length of symptoms can range from 6 months to 7.5 years. Follow up with your health care provider if the pain returns or is not going away. They may be able to help reduce your time with myofascial pain syndrome.
Takeaways
Myofascial pain syndrome is preventable and treatable. If you’re living with chronic pain, speak with your doctor. They can help you create a plan to address your pain and lower your risk of more complications from MFP.
Myofascial Pain Syndrome FAQs
What aggravates myofascial pain?
Myofascial pain syndrome can get worse when it's not treated. Stress on the trigger points linked to the MFP can increase pain or develop additional trigger points, causing more pain.
Will myofascial pain ever go away?
Left untreated, it’s not likely MFP will go away on its own. But with the right treatment plan from your doctor, you have a better chance of living pain-free or with less pain.
Is myofascial pain an autoimmune condition?
Myofascial pain caused by trigger points is not an autoimmune condition. But it can sometimes overlap with autoimmune conditions such as fibromyalgia.
