Myofascial Pain Syndrome

What is myofascial pain syndrome?

Myofascial pain syndrome (MPS) is a chronic pain disorder that usually affects a specific group of muscles in your body. It’s caused by tight, contracted bands of fibers in your muscles called “myofascial trigger points.”

The pain feels like a deep constant ache. When trigger points are pressed, the pain can radiate to surrounding areas. You may also feel a burning or stinging sensation.

MPS is often confused with fibromyalgia, which causes pain throughout the body, not just in a specific area, and does not usually have trigger points.

Most common symptoms

You may feel a pain in one muscle group or part of your body, like the lower back, neck, or jaw.

Main symptoms

• Pain
• Muscle stiffness
• Trigger points (they may feel like muscle knots or tenderness to pushing down on a particular spot)

What causes myofascial pain syndrome?

MPS seems to be set off by some type of event, such as a muscle spasm, a muscle injury, or continual muscle stress (overuse). These may lead to the development of contracted muscle fibers, which become trigger points. The prolonged contraction creates inflammation, which may lead to a painful knot. This is why poor posture is often cited as a cause of myofascial pain syndrome. The posture leads to a prolonged contraction, leading to the knot and corresponding discomfort. As we will discuss later, therapies are aimed at relieving inflammation and improving the function of the muscle and fascia in the area.

What makes you more likely to have MPS?

Factors that may contribute to the development of MPS:

• Poor posture
• Sitting for a long time in awkward positions
• Nutritional deficiencies (e.g. vitamin deficiencies, electrolyte abnormalities)
• Any injury to the musculoskeletal system (muscles, bones, tendons) or disks in the spine
• Fatigue and lack of sleep
• Hormonal changes (menopause)
• Intense cooling of muscles (such as when sleeping in front of an air conditioner)
• Stress and mental health issues (depression, anxiety)
• Underlying inflammatory diseases
• Obesity

What is the best treatment for myofascial pain?

Treatment for MPS typically includes a combination of drugs, trigger point injections, exercise, massage of pressure and trigger points, and physical therapy.

• Stretching. A physical therapist may lead you through gentle stretching exercises through a tolerable range of motion to help the management of muscle pain. If you have trigger point pain when stretching, the physical therapist may spray a numbing solution on your skin.
• Massage. Massaging the tight muscles manually or by acupressure or the use of a massage percussion device (massage gun) applied directly on trigger points may offer instant pain relief and release muscle tension. This is likely due to the improving movement of fascia.
• Heat. Apply heat using a heat pack or warm towel to the painful area to help relieve muscle tension and reduce pain.
• Therapeutic ultrasound. Use of sound waves may increase blood circulation and warm the area, which can bring relief and promote healing in muscles.
• Dry/wet needling. Inserting a needle (dry needling) into the trigger point may break up the tension. Sometimes a numbing agent or steroid is used (wet needling).
• Acupuncture. Speaking of needles, acupuncture is the practice of inserting thin, solid, metallic needles through the skin combined with gentle movements by the practitioner's hands.

Medication 

• Muscle relaxants
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Trigger point injections
• Analgesics (lidocaine patches) applied on affected muscle groups
• Anticonvulsants (lidocaine, pregabalin)
• Antidepressants (duloxetine)
• Botox injections to affected areas

Prevention

• Improving your posture can help treat, but also prevent myofascial pain, particularly in your neck (e.g., “tech neck”). You can improve posture by stretching and avoiding being in the same position for a long period of time.
• Doing exercises that strengthen the muscles surrounding your trigger point will help avoid muscle overuse.
• Try to reduce your stress and practice relaxation techniques.
• Try to keep a regular sleep schedule to improve your sleep.