Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic condition that causes pain in the musculoskeletal system. This pain is confined to a particular area. For example, you might only feel the pain and tenderness in your right shoulder and neck. The pain is typically associated with trigger points in muscles. These trigger points radiate pain to the affected area when pressure is applied to them — and sometimes spontaneously with no pressure. Sometimes this pain can be in what seems to be an unrelated part of the body.

What are the symptoms of myofascial pain syndrome?

The primary symptoms of myofascial pain syndrome are:

  • Localized muscle pain
  • Trigger points that activate the pain

Infrequent but potential symptoms include:

  • Muscle stiffness
  • Fatigue
  • Poor sleep
  • Headaches
  • Postural abnormalities such as hunching, shoulder rounding, or forward head posture (not aligned with spine)

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How is myofascial pain syndrome diagnosed?

There is no imaging or lab test that can identify myofascial pain syndrome. Instead, the syndrome is diagnosed by conducting a thorough examination that may include:

  • Imaging and diagnostic tests to rule out other conditions that may be causing the pain
  • A physical exam in which the physician applies gentle pressure to feel for tight muscle bands that trigger the pain or muscle twitches
  • A visual exam to look for postural abnormalities
  • Questions about when, how and how often you experience the pain, and whether there are things that seem to make it better or worse; the doctor will also ask about repetitive activities or recent injuries that may be factors

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What is the difference between myofascial pain syndrome and fibromyalgia?

Myofascial pain syndrome should not be confused with fibromyalgia, which has similar symptoms. Fibromyalgia is a chronic condition that causes pain and tenderness throughout the body — not just in particular areas — and does not include trigger points. For more information, see the Made for This Moment fibromyalgia page.

A person can have both fibromyalgia and myofascial pain syndrome. That makes it especially important to consult with a medical specialist who can diagnose the difference and apply the proper treatments for each condition.

Myofascial Pain Table 1

What are the treatments for myofascial pain?

Many of the treatments for myofascial pain syndrome are focused on the trigger points. These treatment options include:

  • Cold laser, also known as low-level light therapy, in which the trigger point is exposed to near-infrared light
  • Dry needling, in which the doctor inserts a thin needle into and around the trigger point
  • Wet needling (also known as trigger point injections), which is the same as dry needling except the doctor simultaneously injects a numbing agent or steroid
  • Electrical stimulation, which involves placing an electrode across the muscle affected by a trigger point to cause rapid contractions
  • Massage, including passive rhythmic, active rhythmic and trigger point pressure release
  • Stretching, which is sometimes done in conjunction with other therapies, such as dry needling and ultrasound
  • Transcutaneous electrical nerve stimulation, which involves sending low-voltage electric signals from a small device to the painful area through pads attached to your skin
  • Ultrasound, which uses sound waves to penetrate soft tissues

Other treatment options include:

  • Dietary changes to reduce inflammation and avoid ingredients that seem to trigger pain
  • Heat
  • Behavior modification (exercise, posture, work station setup, yoga, meditation, sleep habits, etc.)
  • Physical therapy, including steps to realign posture, as needed
  • Acupuncture
  • Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen
  • Lidocaine patch
  • Muscle relaxants
  • Steroids
  • Duloxetine

Researchers are investigating the effectiveness of anticonvulsants, antidepressants and botulinum toxin type A (Botox).

 

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Physician anesthesiologists are committed to patient safety and high-quality care, and have the necessary knowledge to understand and treat the entire human body.