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Myofascial Pain Syndrome (Muscle Pain)

Last updated Dec. 1, 2018

Approved by: Maulik P. Purohit MD, MPH


Myofascial Pain Syndrome is a specific form of chronic pain, caused by certain trigger points (called muscle knots). Massage therapy may alleviate pain temporarily, by using trigger point release techniques.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Chronic Myofascial Pain
  • Diffuse Myofascial Pain Syndrome
  • Myofascial Pain Dysfunction Syndrome

What is Myofascial Pain Syndrome? (Definition/Background Information)

  • Myofascial Pain Syndrome is a specific form of chronic pain, caused by certain trigger points (called muscle knots)
  • The fascia (connective tissue that covers the body) gets inflamed and this may involve a muscle or muscle group. Most individuals recover following a muscle injury, overuse, or repetitive strain; however, if the discomfort persists or worsens, it is referred to as Myofascial Pain Syndrome (Muscle Pain)

Who gets Myofascial Pain Syndrome? (Age and Sex Distribution)

  • Myofascial Pain Syndrome occurs worldwide without any geographical distinction, affecting all racial groups
  • It affects all age groups, though it tends to affect middle-aged and elderly adults at higher rates. The elderly (>65years) have the highest prevalence at 85%
  • Women are more susceptible to experience Myofascial Pain Syndrome. Among middle-aged adults (30-60 years), 37% of men and 65% of women are said to experiencethe condition

What are the Risk Factors for Myofascial Pain Syndrome? (Predisposing Factors)

The risk factors for Myofascial Pain Syndrome are:

  • Individuals who have experienced a short term muscle, ligament, or tendon injury or strain, could develop trigger points
  • Individuals using muscle groups, which have not been used for an extended period of time (like after a broken bone fracture)
  • Those who engage in activities that involve repetitive muscular movement
  • Individuals, who express posture imbalance, poor posture
  • Individuals, who experience anxiety or constant psychological stress

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Myofascial Pain Syndrome? (Etiology)

Possibilities of what may start Myofascial Pain Syndrome include:

  • Excessive overuse, or injury on a particular muscle group
  • Lack of physical activity involving any particular muscle
  • Repetitive motions
  • Injury to discs, in between the vertebrae
  • Medical conditions (such as heart attack, stroke, and stomach irritation)

What are the Signs and Symptoms of Myofascial Pain Syndrome?

Most individuals experience the following symptoms with Myofascial Pain Syndrome:

  • Deep aching sensation in the area involved/body region
  • Tender muscle knots
  • Fatigue
  • Sleep disturbance from the pain

Myofascial pain that involve the head and neck may cause:

  • Dizziness
  • Tinnitus (ringing in the ears that does not generate from the individual’s environment)
  • Poor balance

How is Myofascial Pain Syndrome Diagnosed?

A diagnosis for Myofascial Pain Syndrome is as follows:

During a physical exam, trigger points can be identified by applying pressure to the affected muscle. There are different methods of ‘pressing’ (applying pressure) on the trigger points. This can help the physician detect various trigger points types, such as:

  • Active trigger point – an area that causes spontaneous pain at rest, due to extreme tenderness that lies within the muscle. Movement will tend to increase the pain
  • Latent trigger point – an irritated spot that causes muscular tightness, or limited range of movement within the muscle. No spontaneous pain occurs within a latent trigger point
  • Primary trigger point – a trigger point that is directly susceptible to overuse of a muscle
  • Secondary trigger point – an area in the muscle that can be irritated due to the activation of another trigger point

Radiological studies, such as x-rays or MRI scans, may be performed to determine the cause of Myofascial Pain Syndrome.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Myofascial Pain Syndrome?

Complications with Myofascial Pain Syndrome include:

  • Reoccurrence of trigger points, if the muscle remains weak
  • Possible development of fibromyalgia, if pain persists
  • Sleep problems due to uncomfortable sleep positions and constant movement, which may trigger pain

How is Myofascial Pain Syndrome Treated?

Myofascial Pain Syndrome therapies have two goals: Deactivation of trigger points in the muscle, and removal of the risk factors, causing the disorder.

These involve the following:

  • The “stretch and spray” technique, involves spraying a coolant on the affected area, while slowly stretching the muscle
  • Use of pain relievers, like ibuprofen and naproxen, may help improve the symptoms
  • Massage therapy may alleviate pain temporarily, by using trigger point release techniques
  • A slow strengthening of the musclesis necessary, for complete function of the muscle
  • Physical therapy includes stretching and strengthening methods, to help improve coordination
  • Trigger point injection deactivates the trigger points and provides relief to the muscles

How can Myofascial Pain Syndrome be Prevented?

Individuals may prevent Myofascial Pain Syndrome through:

  • Postural training
  • Avoiding prolonged, stationary positioning/posturing
  • Muscular strengthening and stretching

What is the Prognosis of Myofascial Pain Syndrome? (Outcomes/Resolutions)

The length of recovery from Myofascial Pain Syndrome depends on the detection period:

  • If treated within 2-6 months, the pain may resolve within eight weeks, with continuous treatment
  • Symptoms persisting for longer than 6 months, may take an average of 6-7 years of treatment

Additional and Relevant Useful Information for Myofascial Pain Syndrome:

Myofascial Pain Syndrome and fibromyalgia have overlapping features. However, Myofascial Pain Syndrome has specific points that cause pain, while fibromyalgia causes widespread pain throughout the body.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 27, 2013
Last updated: Dec. 1, 2018