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. For reference, there are over 650 named skeletal muscles in the human body, although some figures go up to as many as 840. So, you can imagine just how many trigger point variations are possible.
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.
Could it Be Fibromyalgia?
A common misunderstanding among patients is mistaking myofascial pain syndrome symptoms for fibromyalgia. While the two conditions do resemble each other, they can be easily distinguished through a detailed medical history and physical examination.
Fibromyalgia is also a chronic pain condition, however, it is classified as a constant state of pain that is extended across the entire body. While those with myofascial pain syndrome experience discomfort that can come and go, those with fibromyalgia are in a near-constant state of debilitating discomfort. Fibromyalgia is also typically classified by trouble sleeping at night consistent with restless leg syndrome (RLS).
In fibromyalgia, pain points are referred to as tender points. These come in pairs, such as two in the front of the neck, two in the back of the neck, one in each knee, and so on. Tender points will experience pain when pressure is applied, unlike trigger points, which cause pain in other areas of the body. The muscle pain present in both myofascial pain syndrome and fibromyalgia is why these two conditions are frequently mistaken for one another. However, a correct diagnosis is key to moving forward with an effective treatment plan.
Chiropractic Treatment for Myofascial Pain Syndrome
Chiropractic is an all-natural, drug-free approach to treat myofascial pain and trigger points. In addition to helping alleviate pain in the muscles, chiropractic treatment also helps increase strength, flexibility, and range of motion. With continued chiropractic care, muscles experience an improved endurance; allowing patients to get back to the work and activities they love. Plus, relieved physical and emotional stress results in a better quality of sleep.
At ChiroCare of Florida, our physicians help give myofascial pain syndrome patients a better quality of life. From enjoying the activities they were previously unable to participate in, to sleeping better at night, they enjoy the life they deserve. Not to mention, patients are often able to lower the amount of pain medication they are currently taking, or even eliminate it altogether.
Because chiropractic is a holistic approach to healing, patients also learn healthy habits including diet, exercise, and mental wellness, and stress reduction. Primary chiropractic treatments for myofascial pain syndrome include:
- Myofascial Pain Syndrome (MPS) Therapies – The primary treatment for MPS is a trigger-point injection, often referred to as dry needling. With dry needling, a physician inserts a needle directly into the trigger point as well as the surrounding fascia to loosen up the tight muscle bands.
- Acupuncture – Acupuncture is a form of ancient Chinese medicine similar to dry needling. Acupuncture needles are slightly smaller and are placed into known acupuncture points (acupoints) as opposed to strictly trigger points. Additionally, acupuncture treatment can be used in conjunction with electronic stimulation therapy, known as electroacupuncture. Similar to traditional acupuncture in that the same points are stimulated during treatment, however, needles are then attached to a device that generates continuous electric pulses to soothe tight muscles.
- Physical Therapy – Through a range of varying treatments and physical exercises, physical therapy can assist in the strengthening process for MPS patients. At ChiroCare of Florida, a physical therapist will guide you through stretching exercises to help loosen tight muscle bands. In addition, a therapist will work with you on factors such as poor posture that may contribute to your MPS symptoms.
- Massage Therapy – A massage therapist can utilize specific massage techniques to target trigger points and the surrounding fascia. This gentle but effective treatment loosens taut muscles and relieves stress from trigger points.
