Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic pain condition resulting from repetitive movements of a particular muscle. It is a deep, muscle ache or muscle pain that does not resolve with rest. The hallmark sign of this condition is trigger points. These are tough nodules of tissue located deep within the muscle. They may be small lumps that elicit strange responses.

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Although trigger points are painful when pressed on, they behave differently than other tissues that receive pressure. Commonly, pain is felt far away from the trigger point when the nodule is pressed or activated (referred pain). Trigger points and referred pain lead to this diagnosis. Myofascial pain syndrome usually results in deep, aching muscle pain worse than straining a muscle.

Myofascial pain syndrome usually occurs if you perform a job or home task that requires repetitive motions. For instance, a handyman may experience myofascial pain in their arms from constantly using tools for repairs. If you sit at your desk and use your keyboard with poor posture, you can develop pain in muscles activated through that improper form.

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Also, injury to a muscle from a prior problem can develop myofascial pain. For instance, muscle tears may heal in time, but they can also develop trigger points and cause chronic muscle pain. Finally, stress and anxiety can cause or worsen this condition. Chronic stress activates certain muscles, causing the overuse injury that leads to myofascial pain syndrome.

Your doctor will do a complete assessment and examine you for trigger points in your areas of pain. The initial treatment of myofascial pain syndrome is physical therapy which can stretch out and eliminate trigger points. Non-opiate medications may also benefit. Trigger point injections are the most effective treatment. Local anesthetic medication is injected directly into the trigger point nodule after being carefully identified.

Jose Veliz MD is the medical director of Palomar Spine & Pain, in Escondido, CA (North San Diego County).

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