Myofascial Pain

Anatomy of Fascia

Fascia is a thin, stringy, and multi-layered connective tissue just below the skin that surrounds skeletal muscles, organs, blood vessels, bones, nerve fibers, and other parts of the body. Fascia is essential to the proper functioning of the body, providing shape and support to tissues and organs, easing muscle tension, lessening friction, and tightening reflexively. There are four main layers of fascia: superficial, deep, visceral, and parietal. Each layer contains nerves, making fascia nearly as sensitive as skin.

What Is Myofascial Pain?

Myofascial pain syndrome (MPS) is a nonarticular musculoskeletal pain disorder that causes localized pain and inflammation in the fascia, connective tissue covering the muscles. This condition may involve a single muscle or a muscle group. Healthy fascia is smooth, slippery, flexible, and stretches with you during movement. If fascia is unhealthy or has problems, it can become thicker, stickier, and drier, tightening around muscles. This can limit mobility and cause the muscles to develop painful knots called trigger points.

Some patients don’t experience myofascial pain in the area where it is generated. This is known as referred pain, and it’s possible because all the nerves of the body are part of one large, connected network. Myofascial pain is one of many conditions that affect the fascia, including plantar fasciitis, frozen shoulder, and Dupuytren’s contracture.

What Are the Causes & Risk Factors?

Myofascial pain can be the result of muscle trauma or injury, muscle overuse, or heavy strain on an individual muscle or muscle group, ligament, or tendon. Development of myofascial trigger points may be the result of several contributing factors.

There are many potential causes and risk factors, including:

  • Trauma to the musculoskeletal system, such as injury or surgery
  • Acute injury that didn’t heal properly
  • Repetitive movement that overextends an area of the body
  • Poor or unbalanced posture
  • Lack of exercise or physical activity, due to lifestyle or injury
  • Stress and anxiety, which can cause repetitive, subconscious clenching of muscles
  • Nutritional deficiencies
  • Certain conditions may also increase risks, such as spondylosis, scoliosis, osteoarthritis, osteoporosis, and hypothyroidism

What Are the Symptoms of Myofascial Pain?

Myofascial pain usually worsens with time due to activity and stress, especially if left untreated. For some, the pain can become so severe that it disrupts sleep.

Symptoms include:

  • Pain during movement, or that worsens during activity or stress
  • Localized pain, tender to the touch
  • Pain when pressure is applied to a trigger point
  • Referred pain, or pain that occurs in other areas of the body
  • Burning, aching, stinging, or stabbing pain
  • Reduced mobility or weakness in the area of pain
  • Chronic myofascial pain can also result in other symptoms or problems, such as depression, migraines or tension headaches, fatigue, and sleep disturbances

How Is Myofascial Pain Diagnosed?

Myofascial pain and fibromyalgia are sometimes confused because they are both musculoskeletal pain disorders and share some similar symptoms; however, they are very different conditions. A professional diagnosis is essential to ensure you receive the proper treatment.

Myofascial pain may not produce any visible signs, and it can’t be identified with lab tests or imaging, making diagnosis difficult. Your doctor can provide a clinical diagnosis based on your symptoms, medical history, physical examination, and ruling out other possible issues.

Your diagnosis will include identifying your trigger points.

  • Active trigger points are painful at rest; the referred area of pain may be tender to the touch.
  • Latent trigger points are inactive and not painful at rest, but they can restrict movement and cause weakness; they are only tender when pressure is applied.
  • Satellite trigger points originate from an active trigger point but cause pain within the referred area.

Nonsurgical Treatment

Treatment for this condition focuses on pain relief and helping the tight fascia and muscle fibers to relax. Initially, this may consist of pain medication, muscle relaxants, application of heat and cold, and physical therapy. Treating myofascial pain often requires the use of more than one therapy, and other options, such as massage, stretching exercises, and acupuncture, may also offer relief. If pain persists, your specialist may recommend a trigger point injection using a local anesthetic or steroids. Myofascial pain typically responds more quickly to treatment when it is addressed promptly.

Preventing Myofascial Pain

Addressing any ongoing pain immediately can help prevent myofascial pain syndrome. Proper daily habits can help reduce the chances of developing this issue. If your day includes performing repetitive tasks or remaining in one position for extended periods of time, take breaks to stretch, stand up, walk around, or move in other directions. Maintaining good posture and hydration, regular exercise, healthy sleep and eating habits, reducing alcohol use, and managing stress levels can help you avoid this painful condition.