Myofascial Pain Syndrome

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

Surprising Reasons You're in Pain Slideshow

Myofascial pain syndrome facts

  • Muscle pain, tenderness, and spasm are characteristics of myofascial pain syndrome.
  • Myofascial pain syndrome typically affects muscle in asymmetric areas of the body.
  • The precise cause of myofascial pain syndrome is not known.
  • Myofascial pain syndrome leads to localized pain in the muscle tissue.
  • Poor sleep, fatigue, and stiffness are common in myofascial pain syndrome.
  • Myofascial pain syndrome is simply diagnosed based on the areas of complaints of muscle pain and associated tenderness upon examination.
  • Patients have the best prognosis when one physician oversees a multifaceted treatment approach and monitors the response to various therapies.

What is myofascial pain syndrome?

Myofascial pain syndrome is characterized by muscle pain, tenderness, and spasm. Myofascial pain syndrome usually involves muscle in body areas that are asymmetric or focal, whereas fibromyalgia is typically a diffuse and symmetric muscle pain syndrome that involves both sides of the body.

What are causes and risk factors for myofascial pain syndrome?

The cause of myofascial pain syndrome is unknown. Nevertheless, prior injury, poor sleep patterns, stressful life situations, and depression are common underlying conditions that may play a role in inciting and exacerbating myofascial pain syndrome. It is currently felt that risk factors such as these may lead to a change in the ability of the brain to properly process pain perception (referred to as central pain processing).

Quick GuideChronic Pain: Causes and Solutions

Chronic Pain: Causes and Solutions

Myofascial Pain Syndrome Symptom

Chronic Pain

There are a variety of treatment options for people with chronic pain. The goal of pain management is to provide symptom relief and improve an individual's level of functioning in daily activities. A number of types of medications have been used in the management of chronic pain. Interestingly, chronic pain can sometimes be relieved by stopping smoking and/or caffeine, reducing weight, exercising, optimizing nutrition and/or sleep. Chronic pain requires the diligent monitoring of caring health care providers.

What are myofascial pain syndrome symptoms and signs?

Myofascial pain syndrome causes localized muscle pain. Affected muscles cause neck pain, upper back pain, and lower back pain, generally affecting one side of the body or one side of the body much more than the other. There is commonly tenderness and spasm in the painful areas and there may be tenderness in areas that are not feeling chronic pain.

It is also common for patients with myofascial pain syndrome to have poor sleep patterns with decreased recovery sleep (non-rapid eye movement sleep). This is associated with awakening feeling unrested and daytime fatigue. Stiffness after inactivity is common.

What specialties of doctors treat myofascial pain syndrome?

Myofascial pain syndrome is commonly treated by primary-care physicians, including family medicine doctors, general practitioners, and internists. Other physicians who treat myofascial pain syndrome include physiatrists, orthopedists, and rheumatologists.

How do health-care professionals diagnose myofascial pain syndrome?

Physicians diagnose myofascial pain syndrome based on the areas of complaints of muscle pain and associated tenderness during a physical examination. Extensive laboratory testing is usually unnecessary. There are no appearance changes (redness, warmth, swelling, etc.) in areas of involvement. The appearance is the same as similar areas on the other side of the body. The widespread, diffuse body involvement that is typical of fibromyalgia is not present.

What is the treatment for myofascial pain syndrome?

Optimal treatment of myofascial pain syndrome can be a multifaceted approach. This can include education of the patient, stress reduction, stretching and exercise programs as well as physical therapy rehabilitation, sleep improvement, and medications all best organized by a single physician who tailors the therapies over time by customizing them for the individual patient.

Medications used to treat myofascial pain syndrome can be directed toward various features of the individual's condition and may be used temporarily or longer term. Often trials of medications are used to find the best treatment for the particular patient. For example, trazodone (Serzone) or amitriptyline (Elavil) may be used at bedtime to improve sleep as well as relieve pain; cyclobenzaprine (Flexeril) or orphenadrine (Norflex) can be used at bedtime to relax muscles and to aid sleep; and antidepressants such as sertraline (Zoloft), fluoxetine (Prozac), duloxetine (Cymbalta) can be used to help control pain as can gabapentin (Neurontin) and pregabalin (Lyrica).

What are home remedies for myofascial pain syndrome?

Home remedies for myofascial pain syndrome include exercise, massage, hot water soaks, and resting. Ibuprofen (Motrin, Advil), acetaminophen (Tylenol), or naproxen (Aleve) can be beneficial in relieving symptoms of myofascial pain syndrome.

Quick GuideChronic Pain: Causes and Solutions

Chronic Pain: Causes and Solutions

What is the prognosis of myofascial pain syndrome?

Myofascial pain syndrome can resolve with ideal treatment regimens. However, many patients with myofascial pain syndrome have symptoms for years. Outcomes are best when a multifaceted treatment approach is guided by a single physician who is monitoring the response to various therapies employed.

Is it possible to prevent myofascial pain syndrome?

While myofascial pain syndrome cannot be prevented, it is certainly possible to avoid factors that make the condition worse. This includes avoiding reinjury, minimizing stress, maximizing optimal sleep, and treating any underlying depression.

REFERENCE:

Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

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Reviewed on 9/7/2016
References
REFERENCE:

Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

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