Myofascial Pain Syndrome

What is Myofascial Pain Syndrome?

Myofascial pain syndrome is a chronic pain disorder characterized by sensitive points on the muscle tissue, called myofascial trigger points, causing pain ¹. These trigger points, also known as muscle knots, consist of tight and taut muscle tissue. When these trigger points are touched, they may create pain in the specific area of the trigger point, as well as cause pain in other parts of the body. This is what is known as referred pain.

Often, this condition occurs after a muscle has been used and contracted repeatedly. It may also arise from stress or injury. While everyone experiences muscle tension and discomfort every now and again, myofascial pain syndrome is characterized by worsening or persistent muscle pain. Most individuals with myofascial pain syndrome end up seeking out healthcare treatment in order to alleviate their pain and prevent it from getting worse. The good news? There are many non-invasive methods to treat your myofascial pain syndrome. It is also frequently preventable. In this article, we review this condition further, including outlining the symptoms, causes, prevention tactics, and treatment approaches.

What are the Symptoms of Myofascial Pain Syndrome?

What does myofascial pain syndrome feel like? How do you know if you have it? Frequently, a diagnosis through tests conducted by your doctor will determine if you, in fact, have myofascial pain syndrome. Common symptoms include:

• Deep aching in the muscle or in localized spots.
• Pain that gets worse when the muscle is used or stretched.
• Muscle pain that doesn’t improve over time and progressively gets worse.
• Muscle knots that when pressed produce pain.
• Problems sleeping due to the pain associated with this syndrome.
• Muscle weakness or reduced/limited range of motion.

Other, but possibly less common, symptoms may include depression, fatigue, or other mood fluctuations. The muscle pain may also get worse during physical activity. The following sections also address common questions associated with myofascial pain syndrome and its symptoms.

Can Myofascial Pain Syndrome Cause Chest Pain?

Myofascial pain syndrome can cause chest pain, along with neck and shoulder muscle pain ². However, chest pain can also be a sign of a heart attack, especially in males. If you haven’t recently used those muscles and the pain is accompanied with other heart attack symptoms, such as shortness of breath, dizziness, and cold sweat, seek out immediate medical attention.

Can Myofascial Pain Syndrome Spread?

Yes, the pain associated with myofascial pain syndrome can spread. Frequently, this is referred pain, meaning it’s sometimes not coming from the spot where pain is felt.

Can Myofascial Pain Syndrome Cause Numbness?

In some cases, myofascial pain syndrome may result in tingling and numbness. In fact, one study found that a common cause of hand tingling in desk workers was due to myofascial pain syndrome ³.

Can Myofascial Pain Syndrome Cause Migraines or Headaches?

Interestingly, myofascial pain syndrome is a relatively common cause of headaches ⁴. Further, myofascial pain trigger points are common in individuals that suffer frequent headaches and migraines ⁵. Yet, studies have pointed out that the link remains unclear. Experts theorize that it may be caused by muscular tension pulling on certain structures of the head and neck leading to pain which results in headaches or migraines.

Can Myofascial Pain Syndrome Turn into Fibromyalgia?

Both of these conditions have very similar symptoms. However, fibromyalgia is often more widespread than myofascial pain syndrome. Yet, they can be misdiagnosed as each other from time to time, and some experts consider myofascial pain syndrome as a subset of fibromyalgia, indicating that this condition may eventually develop into fibromyalgia ⁶. Further, pain management and treatment is very similar for these two disorders.

What is the Difference Between Fibromyalgia and Myofascial Pain Syndrome?

The main difference between these two conditions is that fibromyalgia involves widespread pain. Myofascial pain syndrome, on the other hand, includes trigger points or muscle knots, and is mainly limited to muscular pain.

Is Myofascial Pain Syndrome Inflammatory?

Myofascial pain syndrome also frequently coincides with inflammation. This inflammation is located within the muscles or soft tissues of the body causing pain.

What Causes Myofascial Pain Syndrome?

Many incidents can lead to this condition. The following causes are the most common cases.

• Overuse
• Poor posture
• Sitting or lying down in the same position for a long duration
• Nutritional deficits
• Lack of movement or regular exercise
• A musculoskeletal injury
• Fatigue
• Poor sleep
• Hormonal variations
• Emotional turmoil, such as high amounts of stress
• Other inflammatory or chronic pain conditions
• Smoking
• Obesity

Usually, your doctor will conduct a thorough physical exam to diagnose whether or not you have myofascial pain syndrome. The most common cause of this condition is due to repetitive movements causing overuse, as well as sedentary activity. For instance, many individuals experience myofascial pain syndrome and trigger points from sitting in the same position all day at their desk. While this is required for work, your risk can be reduced through good ergonomics and proper posture, as well as frequent movement throughout your day.

Can Myofascial Pain Syndrome Be Cured?

Can myofascial pain syndrome go away? Is it possible to rid yourself of this pain? Absolutely! With proper treatment and care, many methods have shown to be very effective at reducing and eliminating myofascial pain syndrome ⁷.

Is Myofascial Pain Syndrome Genetic?

Myofascial pain syndrome may have some genetic components. However, further studies are needed to determine exactly what these are.

Is Myofascial Pain Syndrome Dangerous?

The syndrome itself is not dangerous, but the side effects it creates may be. Complications can arise in relation to this condition, such as serious difficulty sleeping and the potential development of myofascial pain syndrome into fibromyalgia.

Is Myofascial Pain Syndrome an Autoimmune Disease?

Myofascial pain syndrome is not an autoimmune disease itself. However, it can be influenced and impacted by autoimmune diseases. If an autoimmune disease attacks the connective tissue or other soft tissues of the body, it may result in myofascial pain syndrome.

How to Prevent Myofascial Pain Syndrome?

Even if you’ve already been diagnosed with myofascial pain syndrome, prevention will also be part of your treatment plan. Ideally, treatment involves addressing the cause of your problem, as well as preventing future pain from happening. Plus, there are many things you can do to avoid myofascial pain syndrome in the first place, including the following tips:

Focus on your posture: Consider setting reminders on an alarm for you to adjust your posture. You may also find certain devices to help maintain good posture can help you and ensure your muscles don’t come under stress due to long durations in a slumped position.

Maintain a healthy weight: Excess weight adds strain and stress to the body. It makes it work that much harder than it needs to. Keeping your weight within a healthy range involves balancing a healthy lifestyle including regular movement and a healthy diet.

Try stress management techniques: Stress is a common cause of myofascial pain syndrome. Thus, by lessening the stress in your life, you may reduce your risk of experiencing this chronic pain condition.

Always use correct and proper form: This includes sitting at your desk and during exercise. If you sit at a desk all day, consider setting your area up ergonomically to decrease your risk of pain. When performing any movements repeatedly, use proper form - meaning don’t compensate with other muscles. You’ll also want to take rest breaks to avoid overworking specific muscles or areas.

How to Overcome Myofascial Pain Syndrome?

Myofascial pain syndrome often involves many different treatment methods. The goal is to eliminate pain and improve function, as well as reduce whatever stimulus (such as bad posture) that is causing your symptoms in the first place. Your treatment plan for myofascial pain syndrome will likely include the following methods.

1. Medications

Several medications are used to treat myofascial pain syndrome, including:

NSAIDS (non-steroidal anti-inflammatory drugs): These medications can be found over-the-counter. Examples are ibuprofen (Advil) and acetaminophen (Tylenol). These are only to be used in the short term, since use of these medications for longer than two weeks can lead to serious and severe side effects ⁸.

Muscle Relaxants: If muscle spasms are contributing to your pain, muscle relaxants may be prescribed or suggested.

Botox Injections: Botox consists of botulinum, which is a neurotoxin that has the ability to stop muscle contractions and reduce pain.

Antidepressants: Surprisingly, these medications are common when it comes to treating chronic pain conditions, such as fibromyalgia and neural pain.

Analgesics: These are other pain relievers that may be suggested by your doctor.

Anticonvulsants: These types of medications may also help certain individuals find relief from their pain and muscle spasms.

2. Acupuncture

Research demonstrates that acupuncture is an effective treatment option. One study showed it significantly helped reduce pain in individuals with myofascial pain in the upper trapezius muscles ⁹. Acupuncture does this by releasing endorphins, which are your body’s natural pain relievers. Often, it depends on the individual how well or if this treatment method works for them or not. It may also take various sessions for a person to experience relief.

3. Postural Training: Exercise & Physiotherapy

In today’s modern society, myofascial pain is commonly attributed to poor posture. When you slump forward, various muscles and tissues can become stressed and strained, leading to increased pain. In physiotherapy sessions, your therapist can help fix these issues, as well as prescribe exercises that contribute to good posture. Further, stretches can help relieve muscular tension and pain, which also a physiotherapist can demonstrate and prescribe.

4. Heat Therapy

Heat therapy helps decrease muscular tension by increasing blood flow and encouraging relaxation of the muscle tissue. Consequently, it can help alleviate your pain. Ultrasound therapy may also be used since it works in a similar way to heat therapy. Ultrasounds elevate blood flow to the area, warming it and promoting healing. In turn, this can help your body heal faster and more efficiently.

5. Avoid Sedentary Behaviour

Research has shown links between sedentary behaviour and myofascial pain ¹⁰. The body is made to move. When you sit in one area for long durations, muscles can become strained and tension may build. This can create muscle knots, or trigger points, creating pain in the localized spot and referred pain in other parts of the body. Ensure you participate in regular movement throughout your day. For example, if you work a desk job, consider taking a stretch or walking break every one to two hours. It can help!

6. Trigger Point Therapy

Trigger point therapy is further a viable treatment option to address your myofascial pain. Massage therapists and physiotherapists are trained in this specific therapy, which directly targets these points of tension and pain. We’ll talk more about this topic in the next section in regards to how it is used in massage therapy.

Can Massage Help with Myofascial Pain Syndrome?

Massage therapy has proven to be very effective when it comes to alleviating the symptoms associated with myofascial pain syndrome. Deep pressure massage, in particular, has been cited as a useful modality for myofascial pain ¹¹. Specifically, trigger point pressure release techniques used in massage therapy help eliminate trigger points or knots in the muscle tissue. The pressure applied promotes healing through the warming of the area, as well as releases any stuck tissues or scar tissue. As a result, massage can decrease pain and improve overall function. Research has further found that trigger point therapy is particularly useful for tension points in the head and neck, reducing headaches and migraines ¹².

In addition, massage therapy can help you relax and de-stress. It can be part of your regular self-care routine. Consequently, it may help reduce incidences of chronic stress and offer an outlet for you to unwind. This is especially important when it comes to myofascial pain syndrome, since stress may cause this condition or cause it to worsen. If you regularly experience myofascial pain, using regular relaxation techniques can help decrease flare-ups or incidents of it.

If you’re experiencing myofascial pain syndrome, your massage therapist will likely use a form of trigger point release, combined with deep pressure techniques. The goal is to help release the tight spots in the muscles and help you gain better function and an improved quality of life. Consider choosing massage therapy as part of your multidisciplinary treatment plan to help you get back to the activities you know and love.

References

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2. Chaudakshetrin P, Jalil N, & Prateepavanich P. “Atypical Chest Pain from Myofascial Pain Syndrome of Subscapularis Muscle.” Journal of Musculoskeletal Pain. May 2010, 18:173-179.

3. Oh S, Kim HK, Kwak J, et al. “Causes of hand tingling in visual display terminal workers.” Ann Rehabil Med. 2013;37(2):221–228.

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12. Falsiroli Maistrello L, Geri T, Gianola S, Zaninetti M, Testa M. “Effectiveness of Trigger Point Manual Treatment on the Frequency, Intensity, and Duration of Attacks in Primary Headaches: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Front Neurol. 2018 Apr 24;9:254.