Myofascial Pain Syndrome

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Myofascial Pain Syndrome

Topic Overview

What is myofascial pain syndrome?

Most people have muscle pain from time to time. But myofascial pain is a kind of ongoing or longer-lasting pain that can affect the connective tissue (fascia) of a muscle or group of muscles. With myofascial pain, there are areas called trigger points. Trigger points are usually in fascia or in a tight muscle.

Myofascial pain often goes away with treatment.

What causes myofascial pain syndrome?

Experts don't know exactly what causes myofascial pain syndrome. It may start after:

  • Strain or injury to the muscles, ligaments, or tendons.
  • Using a muscle after you haven't used it for a while, such as after a stroke or after having a broken bone.

What are the symptoms?

The main symptom of myofascial pain syndrome is ongoing or longer-lasting muscle pain, in areas such as the low back, neck, shoulders, and chest. You might feel the pain or the pain may get worse when you press on a trigger point. The muscle may be swollen or hard—you may hear it called a "taut band" of muscle or "knot" in the muscle. Symptoms of myofascial pain may include:

  • A muscle that is sensitive or tender when touched.
  • Muscle pain that happens with pressure on a trigger point.
  • Pain that feels like aching, burning, stinging, or stabbing.
  • Reduced range of motion in the affected area.
  • A feeling of weakness in the affected muscle.

People with myofascial pain syndrome may have other health problems, such as tension headaches, depression, sleep problems, and fatigue. These problems are common in people who have chronic pain.

How is myofascial pain syndrome diagnosed?

To diagnose myofascial pain syndrome, your doctor will ask if you have had a recent injury, where the pain is, how long you have had the pain, what makes it better or worse, and if you have any other symptoms.

The doctor will also give you a physical examination. He or she will press on different areas to see if the pressure causes pain.

You may have tests to see if some other condition is causing your pain.

How is it treated?

Talk to your doctor about the best way to treat your pain. The main treatment may include any of the following:

  • Cognitive-behavioural therapy (CBT). Cognitive-behavioural therapy can teach you how to change your negative thoughts about pain. This can also help you be more active.
  • Cooling spray. This involves using a cooling spray (such as Biofreeze) directly on the skin from the trigger point to the painful area and then gently stretching the muscle. This may be repeated several times.
  • Hypnosis. Hypnosis may help you relax and reduce your pain.
  • Massage therapy.
  • Physiotherapy, which may include stretching and strengthening exercises. It may also include counselling about how to change the things that make the pain worse. For example, you may learn how to adjust your workstation, improve your posture, or change your sleep position to avoid muscle tension.
  • Trigger point shots (injections). A doctor inserts a needle into the trigger point and injects medicine such as a local anesthetic.
  • Transcutaneous electrical nerve stimulation (TENS).
  • Ultrasound.

Your doctor may also recommend non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or ASA. These medicines may help with your symptoms.

Sometimes doctors prescribe certain antidepressants or muscle relaxants that help relax muscles and relieve sleep problems related to myofascial pain.

Other Places To Get Help

Organizations

Arthritis Society of Canada
393 University Avenue
Suite 1700
Toronto, ON  M5G 1E6
Phone: (416) 979-7228
Fax: (416) 979-8366
Email: info@arthritis.ca
Web Address: http://www.arthritis.ca/
 

The Arthritis Society provides funding for arthritis research and offers information on patient care, public education, and self-management of arthritis.


Canadian Orthopaedic Association
4150 St. Catherine Street West
Suite 360
Westmount, QC  H3Z 2Y5
Phone: (514) 874-9003
Fax: (514) 874-0464
Web Address: www.coa-aco.org

Canadian Pain Coalition
1143 Wentworth Street West
Oshawa, ON  L1J 8P7
Phone: (905) 404-9545
Fax: (905) 404-3727
Email: office@canadianpaincoalition.ca
Web Address: www.canadianpaincoalition.ca
 

The Canadian Pain Coalition is a partnership of patient pain groups, health professionals who care for people in pain, and scientists studying better ways of treating pain.


Canadian Physiotherapy Association
2345 Yonge Street
Suite 410
Toronto, ON  M4P 2E5
Phone: (416) 932-1888
1-800-387-8679
Fax: (416) 932-9708
Email: information@physiotherapy.ca
Web Address: http://www.physiotherapy.ca

National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse
P.O. Box 7923
Gaithersburg, MD  20898
Phone: 1-888-644-6226
(301) 519-3153 for international calls
Fax: 1-866-464-3616 toll-free
TDD: 1-866-464-3615 toll-free
Email: info@nccam.nih.gov
Web Address: www.nccam.nih.gov/health/clearinghouse (or www.nccaminfo.org/livehelp/ for live help online)
 

The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) explores complementary and alternative healing practices in the context of rigorous science, trains complementary and alternative medicine researchers, and gives out authoritative information. Send all requests for information and questions about NCCAM to the NCCAM Clearinghouse.


References

Other Works Consulted

  • Bennet RM (2008). Myofascial pain section of Fibromyalgia and chronic fatigue syndrome. In L Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed., vol. 2, pp. 2082–2083. Philadelphia: Saunders Elsevier.
  • Childers MK, et al. (2008). Myofascial pain syndrome. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation, 2nd ed., pp. 529–537. Philadelphia: Saunders Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Primary Medical Reviewer Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine
Specialist Medical Reviewer Nancy Greenwald, MD - Physical Medicine and Rehabilitation
Last Revised April 5, 2011

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