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?
The primary symptoms of myofascial pain syndrome are:

  • Localized muscle pain
  • Trigger points that activate the pain

Infrequent but potential symptoms include:

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


Why Are Trigger Points Hard to Diagnose?
Trigger points are a common cause of several types of spine pain — from neck pain to low back pain — but there’s still a lot doctors have yet to learn about them. Doctors don’t have a set definition for trigger points or understanding of how trigger points produce referred pain.

Trigger points are complex: They’re both easy to pinpoint but hard to diagnose. They can directly cause muscle pain, which may be apparent to detect. But they’re elusive because they can mimic other problems. Myofascial pain syndrome and fibromyalgia are often confused for one another. Jaw pain, earaches, or toothaches that just won’t go away may actually be caused by a trigger point in the neck.

If you have chronic neck pain that doesn’t have a clear cause, ask your personal doctor about whether trigger points could be behind it. Your doctor may refer you to a physiatrist or other spine specialist to test for trigger points in your upper back, shoulders, and neck.


What are the Treatment Options?
Here are some ways you can expect health care providers to provide you with treatment:

  • Myofascial release therapy
    A health care provider such as a chiropractor, osteopathic physician, or physical therapist may treat your myofascial pain syndrome using something called myofascial release therapy. This therapy uses gentle direct pressure and long stretching strokes on trigger points. Progress is measured by seeing if your range of motion and functionality increases or if your pain decreases.
  • Acupuncture or dry-needling
    Some physical therapists and chiropractors use acupuncture or dry-needling to treat myofascial pain. These are alternative medical techniques in which hair-thin metallic needles are inserted at specific points on the body, with the goal of relieving tension.
  • Trigger point injections
    This outpatient procedure takes only a few minutes. The physician inserts a needle through the skin and into the trigger point, injecting an anesthetic mixture into the trigger point. The goal is for the trigger point to relax enough so you can exercise and stretch.
  • Electrical stimulation
    This involves placing an electrode across the muscle affected by a trigger point to cause rapid contractions.
  • Behavior modification
    This consists of exercise, posture, work station setup, yoga, meditation, and sleep habits.
  • Physical therapy
    This includes steps to realign posture, as needed.
  • Nonsteroidal anti-inflammatory drugs
    Possible options are ibuprofen and naproxen to help alleviate the pain.


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