Myofascial Pain Syndrome: Symptoms and Treatment

Introduction

Myofascial Pain Syndrome is a Chronic pain syndrome with nearly 85% of lifetime prevalence. The myofascial pain syndrome is a condition that affects both muscles and fascia. "Myo" means muscles and "fascial" means fascia. Both the genders are equally affected; however inactive people or computer professionals are more likely to get affected.

Myofascial pain syndrome can be both acute and chronic in nature. Acute myofascial pain syndrome requires some basic therapy treatment, however, chronic myofascial pain syndrome, where symptoms have persisted for more than 6 months, would require more focused and persistent therapy. The prognosis for chronic myofascial pain syndrome is bad.

Sensitive areas develop in muscles are prolonged over activity; these sensitive areas are called trigger points. When the condition persists for long enough, it is called Myofascial Pain Syndrome. Muscle pain and tenderness are common findings in Myofascial Pain Syndrome, and it is majorly because of the trigger points. On palpation, these trigger points can be felt as the small bumps or nodule within the muscles. Trigger point is defined as the point which is tender to palpation and the pain is also felt in nearby area (referred pain).
There are 4 different types of trigger points:

Active trigger point - the trigger point which is tender to palpation and then create referred pain as well.

Latent trigger point - it has the potential to be active but is mostly dormant.

Secondary trigger point -it is located in the muscles other than the one in which active trigger point is located.

Satellite trigger point - it becomes inactive because it lies in the vicinity of another trigger point.

The more common muscles to develop trigger points are sternocleidomastoid, trapezius, levator scapulae, infraspinatus and rhomboids. The myofascial pain syndrome symptoms can be visible as the headache, disturbed sleep, anxiety and depression, and generalized fatigue.

Fascia is everywhere in the body and surrounds various structures including body organs, blood vessels, nerves and muscles. Fascia is a white colored connective tissue which is surrounding the various muscle tissues on various levels. It allows the smooth contraction and relaxation of the muscles. It holds the muscle tissues together; the fascia allows smooth movement of muscles so that the tearing, stretching and friction are reduced. The myofascial pain can be felt as the constant dull pain or it can be a sharp pain when the condition is flared up.

Risk factor

Muscle damage - trigger points are developed post-acute muscle injury or muscle stress; a spot within or near the strained muscle is developed.

Poor ergonomics - overuse muscle activities and abnormal postures associated with poor ergonomics can lead to the development of trigger points as well.

Structural and systematic conditions - various arthritic conditions like spondylosis, osteoarthritis and deficiency diseases often lead to myofascial pain syndrome symptoms.

Stress and anxiety - stress and anxiety lead to more of trigger point development. Some personalities are more likely to tense their muscles and hence develop the trigger points.

Deficiency disorders - thyroid and diabetic neuropathy, presence of vit D and folate deficiencies and prolonged chronic infections.

Signs and Symptoms

A tender muscle knot

Persistent pain that worsens

Troubled sleeping due to pain

Deep and aching muscle pain

Complications

There are few complications associated with myofascial pain syndrome:

Sleep Problems - The patients with myofascial pain syndrome may experience trouble while sleeping. And if they move in a direction where the trigger point is hit, it might lead to increased pain and troubled sleep.

Fibromyalgia - both the conditions (fibromyalgia and myofascial pain syndrome) emit pain; fibromyalgia pain is felt throughout the body; however, the myofascial pain syndrome produces local pain.

How do we treat it here at Physio Active

Physical Therapy can be provided to stretch the tighter muscles, strengthen the weaker muscles (using both weight bearing or non-weight bearing exercises) and teach the patient proper ergonomics. Dry Needling, trigger point injections, spray and stretch, ischemic compression, laser, ultrasound and TENS can be used to release the Trigger points. Relaxation techniques should be used so that the person's general health and quality of sleep are improved. Heat and cold therapy can be used to reduce post treatment muscle soreness. Dietary modifications with adequate vitamins (specifically focusing on Vitamin B12 and Folic acid) given to patients would help in recovering from myofascial pain syndrome sooner. Unhealthy foods are linked with the development of Myofascial Pain Syndrome or might increase the symptoms in patients who already the Myofascial Pain Syndrome. Cervical and thoracic modility exercises and Joint mobilization are other techniques that would help a person with Myofascial Pain Syndrome. A person should maintain an overall active and healthy lifestyle.