Myofascial Pain Syndrome Symptoms, Causes & Treatment Options

Most people who suffer from myofascial pain syndrome complain of local muscle pain in addition to referred pain in a specific pattern. The diagnosis is made most often based on clinical findings, and the treatment includes pain medications, muscle relaxants, and anti-depressants. [1]

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Myofascial Pain Syndrome?

Summary

Myofascial pain syndrome is a pain condition during which pressure on a specific part of your muscle can cause pain in that area in addition to other parts of your body that seem unrelated to your original site of pain. This latter type of pain is defined as referred pain. The syndrome often occurs after a muscle has been used repeatedly which leads to worsening pain and discomfort. [2] Your doctor will use your description of symptoms and physical exam maneuvers to guide him or her to the diagnosis of myofascial pain syndrome. Treatment for this chronic disease often involves over-the-counter oral or topical pain medications, muscle relaxants, and antidepressants. Physical therapy may also help ease the pain that you are experiencing. [3]

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Myofascial Pain Syndrome Symptoms

Main symptoms

Myofascial pain syndrome is characterized by localized pain at specific trigger points that are also associated with pain in otherwise unrelated parts of the body. The trigger points are also known as “taut bands” and when pressure is applied to them, a palpable twitch can be appreciated. [4]

  • Localized musculoskeletal pain that is characterized as deep and achy and worsens with time
  • Palpable knots in your muscle
  • Difficulty sleeping as a consequence of the pain
  • Referred pain or pain in seemingly unrelated parts of your body in comparison to your original site of pain

Less frequently, if you suffer from myofascial pain syndrome, you may also experience the following symptoms [4]:

  • Feeling tired
  • Numbness and tingling
  • Abdominal pain and discomfort
  • Headaches
  • The sensation of swelling

Myofascial Pain Syndrome Causes

It is not certain what exactly causes myofascial pain syndrome. It can be caused by muscle tightness that then sets off specific trigger points in your muscles. Trigger points are sensitive areas of muscle fibers that lead to localized pain and referred pain. There are several different factors that may lead to the development of trigger points. [2]

Risk factors for trigger point formation

Various factors can cause trigger points to develop. Often, multiple factors rather than an isolated event will contribute to the formation of trigger points which subsequently cause myofascial pain syndrome. [2]

  • Muscle injury such as a muscle sprain or strain
  • Poor posture
  • Emotional stress
  • Fatigue
  • Anxiety
  • Inflammatory conditions: including appendicitis, cholecystitis, and colitis
  • Excessive exercise or lack of exercise
  • Nutritional deficiencies
  • Heart disease
  • Smoking
  • Obesity

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Treatment Options, Relief, and Prevention for Myofascial Pain Syndrome

Treatment

There are several different ways to treat myofascial pain syndrome and you should discuss these options with your doctor. It may take more than one approach to successfully treat your pain. Treatment typically consists of oral or topical medications, physical therapy, or injections.

The medications that are recommended for the treatment of myofascial pain syndrome include pain relievers, muscle relaxants, antidepressants, and sedatives. It is recommended that you start with over the counter pain relievers such as ibuprofen (Motrin, Advil) or naproxen (Aleve) or topical analgesics such as lidocaine patches or muscle ointments that contain methyl salicylate and menthol (Bengay, IcyHot). Your doctor may recommend stronger prescription pain medications as well. With regards to muscle relaxants, the first-line treatment is tizanidine. It decreases muscle spasticity and has been demonstrated to decrease the pain associated with myofascial pain syndrome in addition to helping affected people sleep better. Tricyclic antidepressants such as amitriptyline may also be prescribed by your doctor to treat your pain. These mediations have been demonstrated to reduce pain and improve sleep.

Physical therapy can help improve your pain through various exercises including stretching, posture training, massages, and the application of heat. All of these techniques can help to relieve your myofascial pain by decreasing the muscle tension in your trigger points.

If your symptoms fail to improve with medications and physical therapy, you can ask your doctor if you are a good candidate to receive injections. Your doctor may recommend the dry needling, local anesthetic injections, or Botox injections. Dry needling involves the introduction of a needle with no associated medicine into a trigger point; just the act of inserting the needle can disrupt muscle tension. Local anesthetic injections help to numb the area of pain. Botox injections will prevent your muscles from contracting and as a result, decrease the pain that you are experiencing. [1] [4]

Prevention

To help prevent the pain associated with your myofascial pain syndrome, you can seek out lifestyle remedies such as exercising, relaxation techniques, and overall wellness. Exercising will help alleviate your pain, especially if you see a physical therapist who can teach you specific exercises personalized to your needs. A physical therapist may additionally apply topical numbing medicine during these exercises to reduce the pain. Additionally, relaxation techniques such as yoga, meditation, or journaling can help decrease your anxiety and stress, and therefore, decrease the amount of pain that you are experiencing. Furthermore, eating a healthy diet and getting regular and adequate sleep will help you overall feel better. [4]

Moreover, once a trigger point is identified, you should ask your doctor if there is an underlying cause that can be treated that is leading to your myofascial pain syndrome. Examples of conditions that can lead to myofascial pain syndrome include scoliosis, weakened joints, low iron, hypothyroidism, and Vitamin D deficiency. [5]

Physical therapy can be used to not only treat but also to prevent the myofascial pain syndrome symptoms. Your physical therapist can teach you exercises that will strengthen your muscles and increase their endurance to decrease the intensity and frequency of pain that you experience. Also, stretching and maintaining good posture can help decrease the likelihood that your trigger points will fire up and cause pain. [5]

When to Seek Further Consultation for Myofascial Pain Syndrome

It is important to see a doctor if your pain is worsening, increasing frequency, or not improving with over the counter ingestible or topical pain medications. You should also see your doctor if your pain is preventing you from sleeping or if you are unable to do daily activities such as going to work. If you are unable to localize your trigger points, a doctor will examine you to localize where your pain is coming from so you can stretch, massage, or apply heat to that area to relieve the pain. Your doctor will be able to help identify if there is a different medication regimen that is appropriate for you or if you are a good candidate for physical therapy.

Furthermore, it is important to see a doctor if you are experiencing any neurologic symptoms such as numbness, tingling, weakness, or decreased sensation in any part of your body. You should also seek further consultation if you have a sudden, acute increase in the frequency or severity of your pain or if you are experiencing fevers, chills, or night sweats. This might indicate that you have a different disease condition that is causing your pain which may require a different treatment regimen in comparison to myofascial pain syndrome. [6]