Myofascial pain syndrome (MPS), also known as chronic myofascial pain (CMP), is a syndrome characterized by chronic pain caused by multiple trigger points and fascial constrictions. Among the symptoms are referred pain, limited range of motion, and sleep disturbance.[1]
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Myofascial pain can occur in distinct, isolated areas of the body, and because any muscle or fascia may be affected, this may cause a variety of localized symptoms. More generally speaking, the muscular pain is steady, aching, and deep. Depending on the case and location the intensity can range from mild discomfort to excruciating and "lightning-like".[2] Knots may be visible or felt beneath the skin. The pain does not resolve on its own, even after typical first-aid self-care such as ice, heat, and rest.[3]
MPS and fibromyalgia share some common symptoms, such as hyperirritability, but the two conditions are distinct. However, a patient may suffer from MPS and fibromyalgia at the same time.[4] In fibromyalgia, chronic pain and hyperirritability are pervasive. By contrast, while MPS pain may affect many parts of the body, it is still limited to trigger points and hot spots of referred pain.[5]
The precise causes of MPS are not fully documented or understood. Some systemic diseases, such as connective tissue disease, can cause MPS. [6] Poor posture and emotional disturbance might also instigate or contribute to MPS.[7]
Massage therapy using trigger-point release techniques may be effective in short-term pain relief.[8] Physical therapy involving gentle stretching and exercise is useful for recovering full range of motion and motor coordination. Once the trigger points are gone, muscle strengthening exercise can begin, supporting long-term health of the local muscle system.[9]
Three different types of drugs are used to treat myofascial pain: anti-depressants (primarily SNRIs), calcium channel blockers such as pregabalin (Lyrica), and muscle relaxants such as Baclofen.
Myofascial release, which involves gentle fascia manipulation and massage, may improve or remediate the condition.[10]
A systematic review concluded that dry needling for the treatment of myofascial pain syndrome in the lower back appeared to be a useful adjunct to standard therapies, but that clear recommendations could not be made because the published studies were small and of low quality.[11]
Posture evaluation and ergonomics may provide significant relief in the early stages of treatment.[12] Movement therapies such as Alexander Technique and Feldenkrais Method may also be helpful.[13]