Understanding Myofascial Pain Syndrome
Myofascial pain, or myofascial pain syndrome (MPS) as it is sometimes called, is chronic muscle pain. While many of us occasionally pull or strain a muscle and feel pain for a short period of time, myofascial pain is a long-lasting (chronic) pain that may need various forms of ongoing treatment before the pain subsides. Myofascial pain can be found anywhere in the body but it is most common in the main torso affecting the neck, back, shoulders and buttocks.
What Are the Symptoms of Myofascial Pain?
Fascia is the connective and surrounding tissues that normally slide over the muscles freely. When a patient suffers from myofascial pain syndrome, the fascia and muscles become tense and aggravated causing pain and sometimes a lack of mobility. There is often a trigger point or knot that is tender and gives additional pain when pressed. Patients can also suffer from referred pain in surrounding areas, making it hard to diagnose the problem.
What Causes Myofascial Pain?
Myofascial pain may be caused by a variety of factors. It can be caused by an injury to the affected muscles or bones. Skeletal problems such as deformities, breaks, arthritis and general age-related wear and tear on the bones and discs can all go on to cause chronic muscle pain and spasms.
Hobbies or jobs that involve repetitive movements are sometimes responsible for myofascial pain. Similarly, inactivity can have the same effect. If somebody is sitting at a desk for too long without breaks for movement or has a broken bone and is unable to move that body part, myofascial pain may develop. Even another chronic illness that renders a patient bedridden or immobile can cause strain and pain in the muscles. Sometimes the cause may be difficult to ascertain and could come down to generally poor posture, health and diet.
Traditional Treatments for MPS
Once diagnosed with myofascial pain by a doctor, there are a variety of traditional treatments and natural remedies that a patient may try. You will possibly be advised to use a combination of drug and physical therapies.
There are a variety of physical therapies that might help myofascial pain:
- Gentle exercise such as walking or swimming
- A series of stretching and strengthening exercises to do at home have been advised by a sports therapist, physiotherapist, or osteopath
- Pilates, yoga and tai chi to build up and gradually strengthen core muscles. You can find routines that are specific to your problem muscle groups and work on stretching and relaxing those muscles.
- Use of a TENS machine
- An intense massage from a sports therapist, physiotherapist, or chiropractor who can identify and work on releasing the tightened muscles and fascia
- Using a hard foam roller or double lacrosse type ball to massage the area and release the tightness in the fascia
A doctor may suggest or prescribe a variety of medications to treat myofascial pain.
Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, aspirin, or naproxen can help reduce inflammation in the area. Other pain relief tablets can be used too, such as acetaminophen or an opioid-based painkiller. Also, sedatives can be used to aid sleep.
Anti-depressants, such as Amitriptyline, are often prescribed in low doses for pain management and are especially effective for this type of pain as it works by altering the way the brain perceives pain signals. It also has the added benefit of having a sedative effect ensuring a pain-free night’s sleep. For this reason, it has to be taken at night and caution must be taken if driving or operating machinery. Another option is muscle rubs that contain heat, cold, or pain-relieving properties.
If physical therapy and medications have not eased myofascial pain, then further medical intervention may be needed.
A steroid or anesthetic injection into the bone or trigger point can be given by a doctor. This may be done in a clinic or under light sedation at a hospital depending where the affected area is. Acupuncture has also been known to treat myofascial pain in some instances.
Recently therapists have been starting to use shockwave therapy. This encourages the muscle and tissue to repair itself after being blasted with soundwaves. A course of three sessions is normally recommended to begin with. Treatment is given at spaced out intervals to allow the area to heal naturally in between. There are certain criteria to be met before this treatment can be given. For example, you cannot have shockwave therapy while taking non-steroidal anti-inflammatory drugs (NSAIDs), and you cannot have this treatment within 12 weeks of having a cortisone injection.
Of course, you may wish to try more natural remedies to ease your myofascial pain:
- Ensure that you have a healthy diet
- Participate in good sleep hygiene
- Use meditation apps and videos
- Have a relaxing bath, especially with Epsom salts
- Alternate using heat and cold packs on the affected area
- Regularly practice deep breathing exercises
As depression, stress and anxiety are all causes of myofascial pain, it makes sense to try and improve your mental health to improve your physical health.
Some doctors feel that if left untreated, there is a risk factor that myofascial pain may develop into fibromyalgia, causing more pain in other areas of the body. As with any chronic pain disorder or syndrome there is a high chance that the patient might develop further sleep and mental health problems.