What is myofascial pain syndrome?
Myofascial pain syndrome (MPS)refers to pain and presumed
inflammation in the body's soft tissues or muscles.
Myofascial pain is a chronic, painful condition that affects the
fascia (connective tissue that covers the muscles). Myofascial pain
syndrome might involve either a single muscle or a muscle group. In
some cases, the area where a person experiences the pain might 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 situation is known as referred pain.
What causes myofascial pain?
Myofascial pain might develop from a muscle injury or from
excessive strain on a particular muscle or muscle group, ligament,
or tendon. Other causes include:
- Injury to intervertebral disks
- General fatigue
- Repetitive motions
- Medical conditions (including heart attack, stomach
irritation)
- Lack of activity (such as a broken arm in a sling)
What are the symptoms of myofascial pain?
Myofascial pain symptoms usually involve muscle pain with
specific "trigger" or "tender" points. The pain can be made worse
with activity or stress. In addition to the local or regional pain
associated with myofascial pain syndrome, people with the disorder
also can suffer from depression, fatigue, and behavioral
disturbances,
How is myofascial pain diagnosed?
The recognition of this syndrome requires a precise
understanding of the body's trigger points. Trigger points can be
identified by pain that results when pressure is applied to an area
of the patient's body. In the diagnosis of myofascial pain
syndrome, four 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 associated with a local or regional pain.
- A latent trigger point is a dormant (inactive)
area that has the potential to act like a trigger point.
- A secondary trigger point is a highly
irritable spot in a muscle that can become active due to a trigger
point and muscular overload in another muscle.
- A satellite myofascial point is a highly
irritable spot in a muscle that becomes inactive because the muscle
is in the region of another trigger pain.
How is myofascial pain treated?
Physical therapy methods are considered the best treatments for
myofascial pain syndrome. Other treatments include a "stretch and
spray" technique, in which the muscle with the trigger point is
sprayed along its length with a coolant, then slowly stretched.
Massage therapy is another treatment, as is trigger point
injection. In the latter form of therapy, anesthesia is injected
directly into the trigger point of the patient.
In some chronic cases of myofascial pain, combinations of
physical therapy, trigger point injections, and massage are needed.
In select cases, medicine is used to treat any co-morbid (existing
simultaneously) conditions, such as insomnia and depression. A case
can be made for using the older tricyclic antidepressants and some
of the newer antidepressants.