What Causes Myofascial Pain?

What is myofascial pain?

Also known as myofascial pain syndrome (MPS), myofascial pain affects the connective tissue covering the muscles, which is known fascia. Myofascial pain occurs when pressure on sensitive points in your muscles causes muscle pain. This condition may affect a single muscle or a muscle group. It can also cause pain in seemingly unrelated parts of your body, called referred pain.

Myofascial pain typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies. It can also result from stress-related muscle tension. The discomfort associated with myofascial pain persists or worsens over time.

What are the signs and symptoms of myofascial pain syndrome?

Signs and symptoms of myofascial pain usually involve deep aching muscle pain with specific trigger or tender points. The pain may persist or worsen over time. Other symptoms may include a tender knot in a muscle, difficulty sleeping, fatigue, depression, and behavioral disturbances due to pain.

What are risk factors for developing myofascial pain?

Risk for myofascial pain can increase when trigger points arise from muscle injury, repetitive movements, lack of activity (like having a broken arm in a sling), stress, or anxiety.

Other risk factors for developing myofascial pain syndrome include:

• Pinched nerve
• Poor posture
• Lack of sleep
• Thyroid disease, diabetic neuropathy, or other metabolic or hormonal issues or changes
• Smoking
• Obesity
• Depression
• Extreme cooling of muscles
• Folate, vitamin D, or other vitamin deficiencies
• Chronic infections

How is myofascial pain diagnosed?

Your pain management physician will conduct thorough physical, neurological, and musculoskeletal examinations. Lab tests may be conducted to identify any diseases, vitamin deficiencies, or infections that could be contributing to your myofascial pain. During the exams, trigger points will be identified by applying pressure to specific areas of the body.

Four types of trigger points can be identified in diagnosing myofascial pain:

• Active trigger point — an area of extreme tenderness that usually lies within the skeletal muscle and is associated with a local or regional pain
• Latent trigger point — a dormant (inactive) area that has the potential to act like a trigger point that may cause muscle weakness or restriction of movement
• Secondary trigger point — an area that becomes painful when applying pressure to another muscle
• Satellite myofascial point — this point flares with pain due to its proximity to another trigger point

The initial exam findings are often confirmed with an electromyography (EMG), which detects neuromuscular abnormalities.

How is myofascial pain syndrome treated?

There are several treatments available for myofascial pain.

Treatments include:

• Nonsteroidal anti-inflammatories
• Acetaminophen (Tylenol) or opioids
• Medications for sleep, depression, or muscle spasm
• Physical therapy
• “Stretch and spray” treatment, which involves spraying the muscle and trigger point with coolant and then slowly stretching the muscle
• Massage therapy
• Trigger point injections, which can be given right in your physician’s office

Can I treat my myofascial pain at home?

Myofascial pain may be managed at home with over-the-counter pain medication, massage, and other relaxation techniques. Rest may also provide relief.

Can myofascial pain syndrome be cured?

While there is not one treatment option that works for every type of myofascial pain, most myofascial pain can be treated by reducing the causes of trigger points. Treatment often leads to the dissipation of trigger points, thus eliminating myofascial pain syndrome. Continued lifestyle changes, like stress management or addressing vitamin deficiencies, can reduce or eliminate the occurrence of myofascial pain in patients.

When should I see a specialist for myofascial pain?

Consider seeing one of our pain management specialists at Neurosurgery One for myofascial pain if you experience muscle pain that does not go away despite rest, massage, and similar self-care measures.