What is Myofascial Pain Syndrome?
The term myofascial is composed of two roots, myo meaning muscle, and fascia meaning bands. Today, fascia is known as the connective tissue which is woven throughout the body. Myofascial pain refers to pain within this soft tissue. The pain originates in specific trigger points which are located throughout the muscles and fascia at various areas of the body. Pain ranges in intensity from mild and bothersome to severe and debilitating.
Myofascial pain syndrome is a chronic pain disorder. With this condition, pressure on the trigger points creates pain in the muscles as well as well as in various places throughout the body.
What are Trigger Points?
Trigger points are tight, hypersensitive spots that can be located in any muscle. Trigger points vary from person to person.
Muscles are made up of alternating bands of cells that form long fibers, which create the tissue’s structure. When trigger points form, they become nodules that exist along a muscle band. The problem with trigger points, aside from the fact that they cause pain, is that they cause referred pain. What this means is that while a person may experience pain at the source of the trigger point, it is more likely that pain is felt in seemingly unrelated parts of the body.
For example, while you may have myofascial trigger points in your neck, referred pain might be felt in your shoulder.
Causes of Myofascial Trigger Points
Myofascial trigger points develop when the muscle undergoes a type of trauma. This can stem from an accident, injury, disease, or occupational-related condition, such as repeated overuse. Activities or hobbies that place a long-term, repetitive strain on the muscles can also create trigger points. Common causes of myofascial trigger points include:
- Poor posture
- Muscle tightness
- Improper office ergonomics
- Repetitive motion
- Emotional stress
Trigger points typically form after the fascia is injured and, for some reason, doesn’t heal properly. Doctors do not know why damage that can heal normally in most patients creates trigger points in others. However, studies suggest that muscle injury in certain individuals leads to abnormalities where nerve cells connect to muscle cells.
For some individuals, myofascial adhesions can cause temporary localized pain and then pose no further threat. For others, pain persists and worsens, creating more and tighter muscle fibers. Doctors call this myofascial pain syndrome. Its underlying cause, and why some individuals suffer painful adhesions, is still unknown.
Symptoms of Myofascial Pain Syndrome
In most individuals, muscle tenderness is the most prominent symptom of myofascial pain syndrome. In patients with MPS, pain is typically regional. This means it will be localized to one anatomic area, such as the buttocks and legs, the abdominal muscles, or the shoulder. Likewise, pain may only last a brief period, subside, and they reemerge days later.
Other symptoms of MPS include:
- Fatigue
- Disturbed sleep
- Depression and anxiety
- Tender knots in the muscle
- Headaches and/or migraines
- Numbness and tingling sensations
- Muscle pain ranging from mild to severe
- Worsening symptoms due to stress, changes in weather, and physical activity
How is MPS Diagnosed?
Diagnosis for myofascial pain syndrome lies with trigger points. Generally speaking, trigger point adhesions can be felt as small, hard knots beneath the skin. The trigger point itself will not be painful when prodded, however, it will cause referred pain in another area of the body.
While trigger points are usually found by a physician through palpation, or a physical examination, other tests such as medical image testing may be requested. In some cases, a doctor may use an MRI or MRE (magnetic resonance elastography) to identify adhesions. In severe cases, a tissue biopsy may be ordered