WHAT IS IT?

The myofascial pain syndrome is a condition of muscles which can mimic pinched nerves or arthritis. It causes pain and tingling which tend to come and go, but are present a good part of the time. Symptoms of the myofascial pain syndrome include tension headaches, and stiff necks. Patients may describe their sensations as a dull ache or a knife-like stabbing sensation; others feel as if their muscles are ‘knotted up’. Because of the vagueness and wide variety of symptoms, many patients go misdiagnosed or even undiagnosed for long periods of time. In fact, some people may be labeled as having psychosomatic disease before they are finally diagnosed.

WHO DEVELOPS THE MYOFASCIAL PAIN SYNDROME?

Myofacial pain syndrome is most commonly seen in people who have had injuries (motor vehicle accidents, falls) and in people whose lifestyles involve repeated physical stress (secretaries, weekend athletes). Most patients are women of childbearing age, although the condition is certainly commonly seen in older individual and in males. Patients with myofascial pain syndromes have fluctuating symptoms. The degree of pain is influenced by physical activity, climate, emotional state and sleeping patterns.

HOW DOES PHYSICAL ACTIVITY AFFECT THE CONDITION?

Resting only temporarily makes the person feel better. Awakening in the morning or after prolonged rest, the patient often complains of a ‘stiffening or jelling’ sensation. After beginning to move, the patient actually feels somewhat better. Ironically, too much activity will once again cause worsening of pain. Sustained posture or isometric exercises cause increased pain. Examples of this include people who hold a book in one position while reading for long periods of time; people who mow their lawn or vacuum for long periods of time; people who type for a prolonged period of time; and people who have just completed a long drive or airplane ride. Interestingly, patients find that when they apply sustained pressure to the same tender points which are causing their symptoms, they obtain some relief.

HOW DOES CLIMATE AFFECT THE CONDITION?

Cold drafts worsen symptoms in many patients. A good number of people complain of increased pain when exposed to humid conditions. Hot baths and dry weather seem to reduce pain temporarily.

WHAT ROLE DO EMOTIONAL STRESSES PLAY?

People often find that symptoms are heightened during periods of tension or anxiety. The condition is not in our minds but periods of stress do make symptoms worse. Patients without an outlet for ongoing stress seem to have the greatest difficulty; college students before examinations, people in the midst of marital problems, people with financial stress.

HOW DO SLEEPING PATTERNS RELATE TO SYMPTOMS?

An interesting study was done at the Mayo Clinic: Medical students were deprived of Stage IV sleep for 48 hours and developed symptoms and findings consistent with the myofascial pain syndrome. When normal sleep was once again permitted, all symptoms abated. A vicious cycle may develop in the patient with myofascial pain in that poor sleep lends to the formation of ‘trigger points’, which then in turn can interfere with sleep.