WHAT IS THE CAUSE OF THE MYOFASCIAL PAIN SYNDROME?

As a result of injury or prolonged physical stress, ‘trigger points’ develop in various muscles. ‘Trigger points’ are tender nodules that refer pain in predictable patterns. When viewed under a microscope, these ‘trigger points’ resemble areas of microtrauma. Once present, excessive contraction or stretch of a muscle containing trigger points will trigger pain. Similarly, complete lack of motion does not permit proper blood flow or proper healing.

HOW DOES YOUR PHYSICIAN MAKE THE DIAGNOSIS OF MYOFASCIAL PAIN SYNDROME?

Because this condition can mimic to many other disorders, it is necessary to perform a detailed physical examination and at times order various laboratory tests. If the physician finds 1) the presence of trigger points and 2) the absence of other conditions to explain the patient’s symptoms, then the patient has the myofascial pain syndrome.

WHAT CAN YOU DO TO FEEL BETTER?

To alleviate symptoms, you must consider ways to reduce or eliminate contributing factors. This includes avoidance of cold drafts, emotional stresses, and prolonged physical stresses, such as sustained postures. You must plan your life in such a way that time is allowed for regular exercise, in order to remain physically active and limber.

WHAT CAN PHYSICIANS DO TO ALLEVIATE SYMPTOMS?

Often to break the vicious cycle of myofascial pain, several measures must be taken for a short period of time.

Physical therapy, consisting of heat and electrical modalities, as well as the ‘spray and stretch technique’ and an individualized home exercise program can help you to regain painless stretch of involved muscles. ‘Spray and stretch’ is a sophisticated technique which only specially trained physical therapists are capable of employing to regain normal stretchability of muscles.

Amitriptyline has been shown to improve sleep patterns and reduce the pain from trigger points. Although originally marketed as an antidepressant, it is quite effective in the myofascial pain syndrome in much lower doses. People whose trigger points are resistant to the above mentioned measures often benefit from ‘trigger point injections’ with a local anesthetic. When used in combination with physical therapy techniques immediately thereafter, by an experienced physician, this is quite effective in restaring normal muscle function and thus reducing pain.

CONCLUSION

This has been a general summary of the myofascial pain syndrome. Specific symptoms and strategies for treatment must be addressed on an individual basis to assure maximal success.