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Myofascial Pain Syndrome Treatment Overview

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Care Plan


First steps to consider

  • If you have symptoms of myofascial pain syndrome, like deep, constant muscle pain and knots that cause pain to radiate, you should see a healthcare provider to get a treatment plan.
  • Treatment typically includes a combination of medications, trigger point injections, exercise, massage, and physical therapy.
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Symptom relief

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  • OTC anti-inflammatory medications like ibuprofen (Advil, Motrin) can help relieve muscle tightness.
  • Stretching and massage of the tense area can also help relieve muscle tension.
  • Placing a heating pad on sore muscles can be soothing and help relax the muscle.
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All treatments for myofascial pain syndrome
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When to see a healthcare provider

Always see a healthcare provider—either a primary care provider or orthopedist—to get a diagnosis of myofascial pain syndrome (MPS). The main symptoms are pain, muscle stiffness, and the development of trigger points (tight, contracted bands of fibers in your muscles).

It’s important to see a doctor right away, ideally before trigger points develop, to improve the chance it can be treated successfully. Your doctor will also want to check for other conditions with similar symptoms, like fibromyalgia.

Getting diagnosed

MPS is usually diagnosed based on your symptoms and a physical exam. There is no specific test that can identify the condition.

What to expect from your doctor visit

  • Your provider may refer you to a physical therapist, who can lead you through gentle stretching exercises to help relieve muscle pain. If you have trigger point pain when stretching, the therapist may spray a numbing solution on your skin. They may also do transcutaneous electrical nerve stimulation (TENS), which uses low levels of electric current to reduce pain levels.
  • If OTC pain relievers don’t help, you may be prescribed one of several types of medications. Options include the antidepressants amitriptyline (Elavil) and duloxetine (Cymbalta), a muscle relaxant like cyclobenzaprine (Flexeril), an anticonvulsant like pregabalin (Lyrica), and a benzodiazepine like clonazepam (Klonopin).
  • Dry/wet needling may be recommended to reduce pain, muscle tension, and stiffness. Inserting a needle (dry needling) into the trigger point may break up the tension. In some cases, the provider can inject a numbing agent or steroid (wet needling, also known as trigger point injections).
  • Your provider may recommend therapeutic ultrasound. Use of sound waves may increase blood circulation and warm the area, which can bring relief and promote healing in muscles.
  • Acupuncture may decrease pain and improve physical function in people with MPS.
  • Injecting Botox into trigger points may help relax the muscles and block feelings of pain.

Prescription myofascial pain syndrome medications

  • Antidepressants: amitriptyline (Elavil), duloxetine (Cymbalta)
  • Muscle relaxants: cyclobenzaprine (Flexeril)
  • Anticonvulsant: pregabalin (Lyrica)
  • Benzodiazepine: clonazepam (Klonopin)

Types of myofascial pain syndrome providers

  • A primary care provider can treat mild to moderate symptoms.
  • An orthopedist is a doctor who specializes in conditions that affect the bones, muscles, and tendons.
  • If you have chronic MPS, you may be referred to a physiatrist, who specializes in pain management.
  • A physical therapist can teach you stretching exercises that help relieve pain.
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