Myofascial Pain

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What is Myofascial Pain?

Myofascial pain is pain and inflammation affecting the fascia – which is the connective tissue that covers the muscles. It could involve just one muscle group or more than one – but in many cases the site of the myofascial pain actually acts as a trigger point that causes pain in other areas of the body. This is called “referred pain.”

Muscles that can be implicated in myofascial pain include:

• Trapezius
• Gluteal muscle
• Ankle
• Knee
• Low cervical
• Second rib

Causes and Symptoms of Myofascial Pain

The symptoms of myofascial pain are normally muscle pain with a trigger point you can specifically locate. Symptoms of myofascial pain typically include:

• Deep pain in localized areas of muscles
• Pain that gets worse when the affected muscle is stretched or strained
• Muscle pain that gets worse or fails to improve with time
• Presence of painful knots in muscles that when pressed produce intense localized or referred pain
• Muscles that are weak, stiff, inflexible, or have reduced range of motion
• Mood or sleep disturbances

The cause of myofascial pain is normally a muscle injury from excessive strain on a particular muscle or muscle group, tendon or ligament. The other causes of myofascial pain can include:

• Trauma to the intervertebral disk
• Experiencing general fatigue
• Repetitive motions
• Certain health conditions, such as stomach irritation or a heart attack
• Lack of activity

Secondary causes that exacerbate myofascial pain include:

• Smoking
• Obesity
• Bad posture
• Hormonal changes
• Nutritional deficiencies

Diagnosis of Myofascial Pain

Recognizing and diagnosing myofascial pain requires knowledge of the body’s trigger points – which can be identified by applying pressure to an area of the body and experiencing pain. There are several different types of trigger points:

Active trigger point, which is an extremely tender area that typically lies within the skeletal muscle. It is associated with local or regional pain.

Latent trigger point, which is a trigger area that is inactive pain-wise, but has the potential to be a trigger point.

Secondary trigger point, which is a very irritable spot in a muscle that may become active due to muscular overload in another muscle area.

Satellite myofascial point, which is a very irritable spot in a muscle that becomes inactive because the muscle is in the region of another trigger pain.

Treatment Options for Myofascial Pain

The best treatment for myofascial pain is ordinarily physical therapy and massage therapy. Another treatment doctors may try is a “stretch and spray” technique, which involved spraying a coolant along the muscle’s length and then slowly stretching it. There is also trigger point injection, which involved injecting anesthesia directly into the trigger point of the patient. In certain cases of myofascial pain, a combination of all the above treatments if needed to effectively manage the condition. Medications for co-occurring health conditions, such as insomnia or antidepressants, may be used to help quell side effects.

Medications are also normally used to help address myofascial pain. These include:

• Nonsteroidal anti-inflammatory drugs, which are over-the-counter drugs like acetaminophen and ibuprofen that can relieve pain and swelling.
• Analgesics, which are pain relievers.
• Muscle relaxants, which can reduce muscle spasms.
• Anticonvulsants, which can relieve pain and reduce muscle spasms.
• Tricyclic antidepressants, which can treat chronic pain, fibromyalgia, and nerve pain – similar conditions to myofascial pain.
• Botox injections, which help prevent muscle contractions and may have pain-relieving effects.

Orthopedic Healthcare at Adena Health System

The team of orthopaedic specialists at Adena Health System strives to get you the best care available with the least amount of down time. The orthopaedic team at Adena follows a conservative approach to care — beginning with the least invasive treatment available -- in the hopes that more major care isn’t necessary. Need help finding a healthcare provider? Search Adena Health System online or call 740-779-FIND (3463).