Have you ever experienced pain you thought was from a joint, tendinitis, or nerve that just wouldn’t go away? The source of your pain might actually be your muscles and fascia! Myofascial pain syndrome (MPS) is a condition where pain is originating from your muscles and surrounding fascial or connective tissue. It’s a common condition that can be easily overlooked because it is diagnosed clinically, meaning there are no imaging or blood test that can detect MPS. There are also no visible signs to determine MPS, such as redness or swelling that you see when tissues are damaged or inflamed.
The pain associated with MPS can be localized around the affected tissues or be referred to and felt in other areas of the body. With MPS, referred pain patterns are specific to the muscle, or muscles, involved. So, the arm pain you’re feeling, for example, may be coming from muscles in the back of your shoulder or neck. Your pain may be acute in nature, meaning it was from a specific incident, or you know when it started, and you’ve had pain for less than six months. Or your pain may be chronic or lasting longer than six months. No matter when your pain started, it is better to seek treatment sooner rather than later for the best long-term outcomes and prognosis.
MPS has many possible causes, including traumatic events such as a sports injury, motor vehicle accident, or a fall. In addition, ergonomic factors such as overuse from repetitive movements or sustained posture such as sitting at a desk for prolonged periods can overload individual muscles and cause dysfunction. Structural factors such as scoliosis, leg length discrepancy, and osteoarthritis change the shape of your joints and cause abnormal movement patterns that result in muscle dysfunction. Or systemic factors such as vitamin D deficiency, iron deficiency, and thyroid issues contribute to MPS as these factors change how the muscle cells can function.
If there are no imaging studies or blood tests that can be done, how do we find MPS and how do we treat it? Firstly, we listen to you and determine your symptoms or what you’re feeling. Usually, MPS symptoms include deep pain in a localized area of a muscle(s) that worsens when it’s stretched or palpated. Pain also fails to improve with time and returns quickly even after rest. Many people also report mood and sleep disturbances with MPS, as nothing really seems to have a lasting effect. Additionally, for many people, the pain is so significant that they avoid exercise or activity altogether for fear of making the pain worse. Then, we check your range of motion and strength and determine how well the involved muscles are functioning. With MPS, there are usually deficits such as weakness and impaired range of motion. Next, we palpate the muscles and find taut bands in the muscle fibers, which are areas of hypercontraction in the muscles commonly referred to as muscle ‘knots.’ These taut bands may be tender to the touch and may contain trigger points which can be very reactive and even twitch involuntarily when pressed. If these taut bands and trigger points reproduce your pain, that helps us determine what muscles and other structures may be involved.
In terms of treatment, our main goals are to relieve pain and correct precipitating factors to try to prevent this from happening again. There are several treatment options we can perform to alleviate taut bands and trigger points such as trigger point dry needling, deep tissue work and myofascial work using tools such as graston and cupping, and cold laser treatments. All of these interventions have been proven to be effective for reducing pain and treating taut bands and trigger points associated with MPS. Myofascial pain syndrome can be a complex issue with many different factors, but it can still be treated! With MPS, it is very important that you slowly but surely return to activity and exercise to help prevent the recurrence of this condition. If you have been having pain that doesn’t seem to be improving with traditional treatment and you need guidance on returning to exercise, we can help! Schedule an appointment with Set PT to learn more!
