What is Myofascial Pain Syndrome?
Myofascial pain syndrome (MPS) is a common chronic pain disorder caused by trigger points and tightness in the fascia, the connective tissue surrounding muscles. Myofascial pain syndrome refers to localized pain stemming from hyperirritable spots, known as trigger points, within the fascia and muscles. These trigger points feel like knots or tight, ropy bands when pressed. They can form anywhere in the body but commonly develop in the neck, shoulders, back, and hips.
Trigger points restrict normal fascia flexibility and blood flow while compressing nerves. This causes referred pain that radiates outward from the trigger point. For example, knee trigger points can cause pain radiating down to the calf. The affected muscles often fatigue quickly as well.
What Does Myofascial Pain Syndrome Feel Like?
The primary symptom is regional aches and pain around trigger points. This may range from mild discomfort to severe and debilitating. Patients often describe the pain as deep and penetrating.
Pressing on trigger points typically reproduces the exact pain pattern felt spontaneously. Stretching and using the affected muscle also intensifies pain. Migraine-like headaches are common when trigger points develop in neck muscles. Limited range of motion and stiffness frequently occur too.
Symptoms may be constant or intermittent, especially if factors like stress or overuse aggravate trigger points. Pain often disrupts sleep and worsens throughout the day. Psychological distress related to chronic pain may also develop.
Types of Myofascial Trigger Points
There are two classifications of trigger points:
Active:
Active trigger points cause pain at rest. They limit the range of motion and refer to pain when compressed. Active triggers result from ongoing muscle tension and injury.
Latent:
Latent trigger points may feel stiff but only cause pain when pressed or stretched. They develop after injuries heal or muscle strain resolves. While not actively painful, latent triggers limit flexibility.
What Causes Myofascial Pain Syndrome?
Trigger points have various root causes including:
• Chronic muscle tension from poor posture, repetitive motions, or imbalances
• Direct trauma such as falls, blows, or punctures
• Joint dysfunctions altering mechanics and movement
• Nutritional deficiencies like low vitamin D, magnesium, or B vitamins
• Inflammation from conditions like arthritis or infections
• High levels of physical or emotional stress
• Structural problems like scoliosis or leg length discrepancies
How Do Healthcare Providers Diagnose Myofascial Pain Syndrome?
To diagnose MPS, providers:
• Palpate for tender trigger points and referred pain patterns
• Assess active and passive range of motion impact
• Rule out other conditions like nerve compression
• Review medical history for related illnesses
• Consider perpetuating factors like poor posture
• Review response to any prior treatments
There are no definitive diagnostic tests for MPS. Skilled manual examination remains the gold standard for identification by providers familiar with myofascial pain.
How Do Healthcare Providers Treat Myofascial Pain Syndrome?
MPS treatment involves:
• Trigger point release via massage, acupressure, or needling
• Warm compresses and muscle-heating modalities
• Improving flexibility and mechanics through physical therapy
• Relaxation training and stress reduction
• Gentle stretching and exercise
• Postural correction
• Medications like non-steroidal anti-inflammatories
• Muscle injections for temporary relief
Are there tests that can help diagnose myofascial pain syndrome?
Diagnosing myofascial pain syndrome (MPS) can be challenging as there isn’t a specific test that definitively confirms its presence. Instead, diagnosis is often based on a thorough medical history, physical examination, and evaluation of symptoms. Trigger points, which are tight knots of muscle fibers that can cause pain, are a hallmark of MPS.
Healthcare providers may perform manual palpation to identify these trigger points and assess their sensitivity. Imaging studies like MRI or ultrasound can help rule out other conditions, but they aren’t typically used to diagnose MPS directly. A successful diagnosis usually involves considering the patient’s reported pain patterns, muscle tightness, and response to palpation.
What kind of healthcare providers treat myofascial pain syndrome?
Several healthcare providers can play a role in diagnosing and treating myofascial pain syndrome (MPS). Primary care physicians, such as family doctors or internists, often initiate the evaluation process. However, specialized care might be needed. Physical therapists are among the professionals who can offer expert care for MPS.
Physical therapists can provide hands-on treatments, exercises, and stretches to alleviate muscle tightness and pain. Pain management specialists may offer injections or other procedures targeting trigger points. Collaborative care involving various specialists can lead to a comprehensive treatment plan tailored to the patient’s needs.
Myofascial pain syndrome vs. fibromyalgia: What’s the difference?
Myofascial pain syndrome (MPS) and fibromyalgia are two distinct but often confused conditions. MPS primarily involves localized pain in specific muscle groups, known as trigger points, which can refer pain to other areas. These trigger points are tender and tight knots in the muscles. On the other hand, fibromyalgia is characterized by widespread pain throughout the body, often accompanied by fatigue, sleep disturbances, and cognitive issues (“fibro fog”).
While both conditions involve pain, fibromyalgia’s pain tends to be more diffused and involves multiple tender points. Additionally, fibromyalgia is often associated with heightened sensitivity to touch and other stimuli. While there can be overlapping symptoms, understanding the differences between MPS and fibromyalgia is crucial for accurate diagnosis and appropriate treatment.
