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Myofascial Pain Syndrome

Definition


Disease: Myofascial Pain Syndrome Myofascial Pain Syndrome
Category: Bones, joints, muscles diseases
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Disease Definition:

The chronic form of muscle pain is referred to as myofascial pain syndrome. Trigger points are the sensitive points in the muscles around which the pain of myofascial pain syndrome centers. The pain can spread throughout the affected muscle. These trigger points can be painful when touched.

From time to time, nearly everyone experiences muscle pain that generally resolves in a few days. However, muscle pain that persists or worsens is the thing that people with myofascial pain syndrome have. Myofascial pain that is caused by trigger points has been linked to many types of pain, including pelvic pain, headaches, arm and leg pain, low back pain, neck pain and jaw pain.

In many cases, treatment for myofascial pain syndrome can bring relief. Medications, physical therapy or trigger point injections are included in treatment options.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

The following may be included in signs and symptoms of myofascial pain syndrome:

 

  • Joint stiffness near the affected muscle
  • Pain that persists or worsens
  • Muscle stiffness
  • Area of tension in one's muscle that may feel like a knot or tight spot and may be particularly sensitive to touch
  • Deep, aching pain in a muscle
  • Difficulty sleeping due to pain


When experiencing muscle pain that doesn’t go away, or when the typical self-care measures one uses in these situations such as massage or rest stop working, one should see the doctor.

Causes:

After overuse or injuries, sensitive areas of tight muscle fibers can form in a person’s muscles. Trigger points is the name of these sensitive areas. Strain and pain throughout the muscle can be caused by a trigger point in a muscle. myofascial pain syndrome is when this pain persists and worsens. Trigger points in the muscles are the cause of myofascial pain syndrome. One's risk of muscle trigger points may increase due to certain factors:

Age:
In middle-aged adults, myofascial pain syndrome is more likely to occur. Younger people are not as likely to experience myofascial pain syndrome, and it is thought that they cope better with stress and strain.

Stress and anxiety:
Trigger points are more likely to develop in the muscles of people who frequently experience stress and anxiety. One theory says that these people may be more likely to clench their muscles, a form of repeated strain that leaves muscles susceptible to trigger points.

Inactivity:
One may experience trigger points in his/her muscle as he/she starts to move it during recovery from a condition that has made him/her unable to use that muscle such as after surgery or after a stroke.

Sex:
Women are more likely than men to experience myofascial pain syndrome and it isn't clear why.

Muscle injury:
Forming trigger points can be caused by stress on the muscles. For instance, trigger points may be caused by an injury in the muscle, and the risk may increase by repetitive stress.

Complications

Complications:

Over time, myofascial pain syndrome can lead to other complications such as:

Sleep problems:
It may become difficult to sleep at night because of the signs and symptoms of myofascial pain syndrome. One may have trouble finding a comfortable sleep position, and he/she might hit a trigger point and wake up when moving at night. He/she can talk to the doctor about medications that can help him/her sleep at night.

Muscle weakness:
Due to inactivity, myofascial pain syndrome may lead to muscle weakness over time. Muscle weakness may happen because the pain that one feels may make him/her reluctant to use the affected muscle, though trigger points generally don't hurt the muscles.

Fibromyalgia:
The chronic condition that causes widespread pain is called fibromyalgia. Myofascial pain syndrome is suggested in some research to develop into fibromyalgia in some people. It is believed that the brains of people with fibromyalgia become more sensitive to pain signals overtime. It is also believed that myofascial pain syndrome may play a role in starting this process.

Treatments:

Medications, trigger point injections or physical therapy are typically included in the treatment of myofascial pain syndrome. There is no conclusive evidence that supports using one therapy over another. Treatment preferences and options can be discussed with the doctor. To find pain relief, one may need to try more than one approach.

MEDICATIONS:
The signs and symptoms of myofascial pain syndrome may be treated by medications that include the following:

Depression medications:
A class of medications for depression that is called tricyclic antidepressants may help the patient sleep and relieve pain.

Nonsteroidal anti-inflammatory drugs (NSAIDs):
Though some people find that these drugs are not helpful, they may relieve muscle pain.
Naproxen and ibuprofen are included in over-the-counter NSAIDs. By prescription, other NSAIDs are also available.

TRIGGER POINT INJECTIONS:
A needle is inserted into a trigger point in the muscle during a trigger point injection. The needle may be inserted into several places in and around the trigger point. The tension in the muscle that causes the trigger point may be relieved by trigger point injections, which are sometimes called needling.

Each time the needle is inserted, a small amount of a numbing medication such as an anesthetic is injected. To relieve pain around the trigger point, corticosteroid medications may be used as well.

PHYSICAL THERAPY:
Based on the signs and symptoms of the patient, a physical therapist can devise a plan to help relieve the pain. The following may be involved in physical therapy to relieve myofascial pain syndrome:

Finding causes of pain:
The physical therapist may help the patient recognize and correct factors that may contribute to the patient's pain. For instance, the physical therapist may guide him/her through exercises to correct his/her posture if poor posture is causing muscle stress in the lower back of the patient.

Stretching:
To help ease the pain in the affected muscle, a physical therapist may lead the patient through gentle stretching exercises. The physical therapist may also spray a numbing solution on the skin of the patient if this patient feels trigger point pain when stretching.

Massage:
To help relieve the pain, a physical therapist may massage the affected muscle. And to release tension, the physical therapist may use long hand strokes along the muscle or place pressure on specific areas of the muscle.

Prognosis:

Not Available

Expert's opinion

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