Myofascial pain syndrome is a regional pain disorder characterized by localized hypersensitive muscles that radiate pain. It is very common and can result in significant disability. It is often associated with anxiety, poor posture, repetitive strain injuries, sleep deprivation and traumatic injuries.
The muscles hurt because they are constantly active without a rest break. As this continues, the muscles get tight and stiff resulting in worsening pain. If this cycle is not broken, the pain continues to worsen until normal activities are extremely difficult.
The symptoms of myofascial pain syndrome can be very non-specific and can include:
• Sudden onset
• Pain in a distributed pattern
• Decreased joint range of motion with increased sensitivity to stretching
• Muscle weakness due to pain with no muscular atrophy
• Palpation of the painful site resulting in a reproduction of the characteristic pain
• A palpable muscle band with a local twitch response
Other diseases that can mimic myofascial pain include:
• Chronic pain syndrome
• Joint osteoarthritis
• Psychological disorders
• Polymyalgia rheumatica
Myofascial pain syndrome can often be treated with physical therapy focused on massage and progressive stretching and strengthening. Simple medications such as acetaminophen and nonsteroidal anti-inflammatory medications such as naprosyn or ibuprofen. If greater pain control is needed, muscle relaxants and oral pain medications may be helpful.
Trigger point injections can be helpful for immediate relief of muscle tightness and pain. In addition, cortisone and botulinum toxin have also been used in injections for longer term relief.
Borg-Stein J, Simons DG. Focused review: myofascial pain. Arch Phys Med Rehabil. 2002 Mar;83(3 Suppl 1):S40-7, S48-9.
Panagos A. Rehabilitation Medicine Quick Reference-Spine (ed. Buschbacher R.M.) New York: Demos Publishing; 2010. p. 102-103.