Understanding myofascial pain syndrome

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Understanding myofascial pain syndrome

In simple terms, myofascial pain syndrome (MPS) refers to muscle pain and inflammation in the body’s soft tissues.  And there’s a good chance many of you have experienced at one time or another symptoms of it.  Ever had a nagging, burning pain between your shoulder blades in the neck or low back?  Even though painful, for most of us, this pain and condition is usually short lived and resolves on its own.  But for others, MPS is a chronic condition lasting a long time. 

What is myofascial pain syndrome?

MPS is a chronic, painful condition that affects the connective tissue that covers the muscles.  It refers to pain and presumed inflammation in the body’s soft tissues or muscles.  It could 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.  It is believed that the actual site of the injury or the strain prompts the development of a trigger point that can cause pain in other areas, which is known as referred pain.

MPS is not limited to only certain areas of the body.  It can happen in multiple areas but is most common in the neck and shoulder blade area and is associated with trigger points.  A trigger point is a knot of muscle spasm that when you touch it, it refers pain to another area. 

Causes of myofascial pain syndrome

There are certain causes for the development of MPS:

·      Muscle injury

·      Excessive strain on a particular muscle or muscle group, ligament, or tendon

·      Injury to muscle fibers

·      Repetitive motions

·      Lack of activity such as having a broken arm in a sling

·      From a fall or a motor vehicle accident

Women are more likely to than men to develop MPS.  Neck and shoulder injuries are very prone to developing MPS as these are often complex injuries with multiple factors including muscle, joint, and disc problems. 

Symptoms of myofascial pain

The symptoms of MPS primarily cause localized muscle pain that involve specific “trigger” or “tender” points which may be felt as “knots” of tissue under the skin.  Affected muslces cause neck pain, upper back pain, and lower back pain, that usually affect one side of the body.  Tenderness and spasm in the painful areas are common and there may be tenderness in areas that are not feeling chronic pain.  Activity or stress can bring on stiffness making the pain worse.

It is also common for people with MPS to have poor sleep patterns with decreased recovery sleep (non-rapid eye movement sleep).  This is associated with awakening feeling unrested and daytime fatigue. 

How is it diagnosed and treated?

Diagnosis of MPS is based on the areas of complaints of muscle pain and associated tenderness during a physical exam as there are no outward appearance changes such as redness, warmth, or swelling.  It is generally unnecessary to do any extensive lab testing.

MPS can be treated by primary-care physicians, including family medicine doctors, general practitioners, and internists.  However, it can also be treated by orthopedists and rheumatologists.

Treatment for MPS can be multifaceted which can include educating the patient, stress reduction, stretching and exercise programs as well as physical therapy rehabilitation, massage therapy, sleep improvement, and medications tailored for each individual patient. 

What is the prognosis of myofascial pain syndrome?

The goal is to help MPS resolve with various treatment regimens.  However, many people with MPS have symptoms for years.  If a person with MPS uses a physician they trust and who has experience in treating this condition, the outcomes will be better as long as a multifaceted treatment approach is being used.