Muscle Pain that Won't Stop
What is Myofascial Pain Syndrome?Myofascial pain syndrome is a condition that causes chronic muscle pain. The pain originates in the muscles and the fascial linings. The fascial linings are the tissues that surround the muscles.
The syndrome is usually associated with trigger points. Trigger points are small, tender areas found in muscles, fascia, ligaments and tendons. The trigger points can sometimes be felt. If you have one you may be able to feel a small nodule ( also known as a taut band) in the muscle. Pressing on the trigger point produces pain that can radiate through the muscle or to other parts of the body. Pushing on the trigger point can sometimes make the muscle twitch.
What causes it?The exact cause of myofascial pain syndrome is unknown, but it tends to occur after other injuries. Sometimes a direct trauma starts the syndrome. In other cases it develops from repetitive stress, such as from bending and lifting repeatedly. And for others it develops after periods of inactivity. Stress and anxiety often trigger myofascial pain syndrome.
What are the symptoms?
- Muscle pain with activities and stretching
- Tender knots in the muscles
- Aching
- Stiffness
- Muscle weakness
- Difficulty sleeping
- Headaches
- Radiating pain
- Increased pain with stress
- Increased pain with weather changes
Common treatment for myofascial pain syndrome includes physical rehabilitation, medications and trigger point injections. Acupuncture is sometimes used as an alternative.
- Physical rehabilitation- A physical or occupational therapist can perform treatments such as superficial heat, deep heat and electrical stimulation. The therapist may perform techniques such as massage, range of motion exercises, stretching and joint mobilization. The therapist will also teach you an exercise program that you can perform on your own at home. The home exercise program will help you to become stronger and more flexible. You should also learn better body mechanics so that you decrease stress on the effected areas.
- Medications- Your doctor may prescribe medications to help with the pain. Common medications are NSAIDS (anti-inflammatories such as ibuprofen) and analgesics such as acetaminophen. Stronger analgesics and muscle relaxants may also be prescribed. Topical medications that can be applied directly onto the skin are sometimes helpful.
- Trigger point injections- Your doctor may use a small needle to inject local anesthetics, saline or small amounts of steroids directly into the trigger points. Before the injection the muscle may be sprayed with a topical anesthetic. After the injection the muscle may be passively stretched. Some people notice immediate pain relief, while other note soreness initially before the pain decreases. Some doctors also use injections of botox into or surrounding the trigger points.
- Acupuncture- Acupuncture is an alternative treatment option for myofascial pain syndrome. The acupuncturist will insert small needles into specific areas of your body to encourage energy to flow freely.
Sources:
Jackson c. Tan Practical Manual of Physical Medicine and Rehabilitation Walter R. Frontera, Julie K. Silver Essentials of Physical Medicine and Rehabilitation