Myofascial Pain Syndrome is a painful condition characterized by chronic and sometimes severe localized pain, reduced mobility, muscle tenderness, sleep disorders and mood variations. Pain occurs mostly in areas such as head, legs, lower back, neck, shoulders and arms. Pain varies in intensity with time of the day, type and intensity of physical work and stress.
Myofascial Pain Syndrome Description:
Clinically MPS is defined as ” A hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band.” Myofascial Pain Syndrome can be of head, neck, shoulder, cervical, thoracic, spinal, and hip.
Myofascia is a thin-film layer or lining, which surrounds the muscle fibers, to give them support and proper shape. “Myo” is a prefix for anything that is related to muscle, and “Fascia” means binding tissue, so myofascia is a muscle binding tissue. The pain is developed due to the formation of trigger points on Myofascia. Trigger points are sensitive areas of tight and sore skeletal muscle knots that can develop on myofascia through out the body due to injury or overuse. When these trigger points are pressed, pain can be felt in that area and also in other parts of the body far away from the pressed area, and this pain is known as referred pain. Trigger points are of two type – Active and Latent. Active trigger points are painful not only during activity but also rest. Whereas Latent trigger points are painful only when compressed.
Causes of Myofascial Pain Syndrome
At this stage it is difficult to pinpoint the exact causes of Myofascial Pain Syndrome. However, research revealed that continuous bad body posture, unrelenting pressure on muscles, surgery, emotional stress, injured invertebral disc, visceral disease, nutritional deficiency, chilling, and lack of joint movements due to limited or permanent inactivity are causes associated with myofascial pain syndrome. Recent studies also revealed that Myofascial Pain Syndrome is more prevalent in people, such as athletes, construction workers, weight lifters, base ball catchers, who are involved in activities that put undue and repeated pressure on their muscles.
Symptoms of Myofascial Pain Syndrome
People with Myofascial Pain Syndrome may exhibit the following symptoms
Persistent, deep, dull, stagging pain in the effected muscle that doesn’t go away even after enough resting and massage.
Pain doesn’t allow to sleep properly. Certain positions while sleep, activate the trigger points, which may awaken the person.
Presence of a tender knot in muscle when touched.
Stiffness and weakness in muscle after a period of inactivity such as sitting too long or waking up after sleep.
Increased sensitivity to cold.
Slight increase in temperature at the area of Trigger Point.
Trigger Point Examination:
To test the presence of taut bands and twitch response through palpation of the affected area. Different types of palpation are applied as described below:
Flat palpation – Moving the finger with moderate pressure over the muscle fiber.
Pincer palpation – Compressing the muscle fibers between finger and thumb.
Twitch response – Running a finger over a taut band may result in a twitch response.
Myofascial Pain Syndrome Treatment:
1. Spray and Stretch Method:
Apply a vapocoolant spray such as Flouri-Methane and stretch the muscle. Repeat this action several times and close it with application of moist heat.
2. Application of Moist Heat:
Moist Heat through hot packs or hot-tub bath shall be applied at the effect area. Care should be taken not to apply dry heat, as it absorbs the skin moisture making it more painful.
3. Deactivating the Trigger Point:
Trigger points can be deactivated by applying tolerable and continuous pressure on the TP area. Pressure can be applied with thumb or finger, and it can be done in one session or in multiple sessions until TP is deactivated.
4. Ice Therapy:
Ice should be applied for 5 to 15 minutes at the TP at least five times in 24 hours. The interval between subsequent application should be at least one hour. The objective is to make the TP numb and subsequently deactivated.
5. Posture corrections (Biomechanics):
Poor posture can cause and aggravate MSP. So it is important to correct the poor postures while sitting, standing, sleeping and driving. If any furniture is causing problems or is behind the bad posture, then the same shall not be use.
Adding vitamins such as B1, B6, B12 and C, Folic acid and minerals such as calcium, iron, magnesium and potassium to diet may help in the treatment of MSP.
7. TENS Treatment:
Transcutaneous electrical nerve stimulator (TENS) is a small battery powered unit. Electrodes of the unit are placed along the painful muscle and small electric simulations are applied to relax the tensed muscle and reduce the pain.