Definition

Myofascial pain syndrome (MPS) is a specific type of pain in the muscles and soft tissue. The pain is associated with trigger points, small areas of tight muscle fibers. These points are extra sensitive to pressure.

Causes

The exact cause of myofascial pain syndrome is not clearly understood. It is believed that excessive strain or trauma to a muscle, ligament, or tendon may cause a trigger point to develop. The trigger point can remain even after the injury or strain has healed.

Some factors that may be associated with the development of trigger points include:

• Injury, especially to disks in between the spinal bones
• Fatigue
• Repetitive motions

Risk Factors

Myofascial pain is more common in women and older adults.

Factors that may increase your chances of getting myofascial pain syndrome include:

• Recent injury
• Inactivity
• Stress and anxiety

Symptoms

Symptoms may include:

• Prolonged muscle pain
• Intensive pain when pressure is applied to a specific area (painful knot in the muscle)
• Pain that worsens with activity or stress

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done, paying special attention to muscles that are painful. The doctor will look for specific areas that are very sensitive. The diagnosis is often made based on history of symptoms and presence of trigger point.

An electromyography may be done to test the electrical activity of the muscles. It may help to rule out other causes of muscle pain or find what may be creating the trigger points.

Treatment

Treatment will start by identifying what may be contributing or worsening the pain. Your doctor or a physical therapist will use this information to help build a treatment plan.

Muscle stretching and strengthening exercises will be used to decrease tension of trigger points.

Other steps that may help decrease trigger points include:

• Cooling spray and ice may help before, during, or after activities.
• Dry needling or acupuncture—both techniques place needle into the trigger point. The needle may help loosen the trigger point tissue.
• Massage therapy
• Medication injection—pain or anti-inflammatory medication injected directly into the trigger point may temporarily relieve some pain.
• Medication patch containing an anti-inflammatory medication

Prevention

Since the cause of myofascial pain syndrome is not clear, there are no direct preventative steps. Avoiding excess stress on muscles may help prevent the development of trigger points.

Ask about ergonomic support in your workplace. Proper ergonomics can help reduce stress, especially in tasks with repetitive motion. Some examples of ergonomics include learning correct lifting techniques, improving your posture, and sitting correctly.

Family Doctor—American Academy of Family Physicians http://www.familydoctor.org

Health Canada http://www.hc-sc.gc.ca

Myofascial pain syndrome: Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/health/diseases_conditions/hic_Myofascial_Pain_Syndrome
Updated July 7, 2014. Accessed February 23, 2015.

Myofascial pain syndrome. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated August 1, 2014. Accessed February 23, 2015.

Myofascial pain syndrome. StopPain.org—Beth Israel Medical Center website. Available at:
http://www.stoppain.org/pain_medicine/content/chronicpain/myofascial.asp
Accessed February 23, 2015.