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

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 affected 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.

How is myofascial pain syndrome diagnosed?

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, 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).

Medically Reviewed by a Doctor on 2/19/2015
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