An estimated 85% of the population will experience myofascial pain at some point during their lifetime. Myofascial pain is associated with inflammation or irritation of muscle or the fascia (connective tissue) surrounding the muscle. Tens of millions of Americans suffer from myofascial pain.
Myofascial pain syndrome (MPS) is a chronic pain condition that typically occurs in muscles that are contracted repetitively. This causes sensitive pain points, or trigger points, that radiate pain upon compression in the impacted muscle as well as in other parts of the body.
Trigger points are characterized as either active or latent. Active trigger points generate pain in response to movement or at rest, while latent elicit pain upon compression. Stress, anxiety, overexertion, and underactivity can all activate trigger points.
MPS is often misdiagnosed due to a lack of specific laboratory indicators and imaging evidence. It’s often confused with other conditions including fibromyalgia and pain from degenerative changes in the intervertebral discs. Unlike other pain syndromes, pain associated with MPS typically presents in a single area or quadrant of the body. It is also possible for a patient to suffer from both MPS and fibromyalgia or that multiple trigger points in different parts of the body are causing widespread pain.
Symptoms of Myofascial Pain Syndrome:
- Deep, aching, throbbing pain in a muscle with accompanying pain and stiffness
- Small bumps, knots, or nodules—referred to as trigger points– in the muscles that are tender and generate pain when touched. Compression of trigger points may elicit a contraction of the muscle fiber, known as the twitch response.
- Restricted range of motion when stretching the affected muscle
- Weakening of the affected muscle
- Difficulty sleeping due to pain
- Headaches or migraines
How is Myofascial Pain Syndrome Diagnosed?
Myofascial trigger points contain taut bands that do not stretch or elongate normally. They cannot be actively or passively stretched to their full length without causing pain, and are diagnosed through a manual examination of the muscle.
According to this article about Myofascial pain syndromes in the Journal of Hand Therapy, there is as yet no readily available laboratory diagnostic test that identifies the trigger point, although the taut band can be seen on diagnostic ultrasound.
The study’s author, Dr. Robert D. Gerwin from the Pain Treatment Center and Department of Neurology at The Johns Hopkins University, also notes that a variety of other conditions may be associated with MPS. They include:
- Recurrent vaginal yeast infections
- Gout in men and postmenopausal women
- Cervical radiculopathy (pinched nerve in the neck)
- Osteoarthritis
- Rheumatoid arthritis
- Fractures of the shoulder and arm
- Fibromyalgia
- Depression
Natural Treatments for Myofascial Pain Syndrome
Low Level Light Therapy (LLLT):
Also known as phototherapy or photobiomodulation, LLLT exposes trigger points to red and near-infrared light generated by lasers, filtered lamps, or light-emitting diodes (LED). LLLT is commonly used to reduce inflammation, augment tissue repair, and promote tissue and nerve regeneration.
One study showed that patients suffering from MPS experienced decreases in the severity of their pain after four weeks of LLLT. Another study found that “LLLT applied to trigger points could significantly relieve myofascial pain and was effective in relieving cervical ROM (range of motion) limitations.”
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Also called intramuscular stimulation, dry needling involves the insertion of thin, sharp needles in and around MFS trigger points. It is commonly performed by physical therapists to decrease tightness, increase blood flow, and reduce pain.
An article that appeared in the Journal of Orthopaedic and Sports Physical Therapy stated that “dry needling may release the tight muscle bands associated with trigger points and lead to de-creased pain and improved function.”
Also known as trigger point injections, wet needling is the same as dry needling except that it also involves the injection of a numbing agent or steroid
A randomized, placebo-controlled trial found that massage was successful in reducing pain associated with MPS but that “attaining full resolution of trigger points may require multiple treatment sessions.”
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A review of studies using manual acupuncture for myofascial pain syndrome found that stimulation of the trigger points might be successful in relieving pain and reducing muscle irritability in MPS patients.
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A study found that a planned yoga program led to significant improvement in the quality of health, physical strength, cervical range of motion, and pressure threshold of the trigger points, decreasing the disability and pain for the patient with cervical myofascial pain syndrome.
A randomized controlled trial found that “Stretching cervical muscles involved in chronic myofascial pain syndrome for 30 seconds was optimal in achieving pain relief.
CBD:
A randomized double-blind trial found that in patients with myofascial pain that affects the masseter (jaw) muscles, topical CBD significantly reduced pain intensity.
CBD has been shown to reduce anxiety and improve sleep, changes that can result in improvements in MPS.
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This technique trains people to improve their health by teaching them to control bodily processes such as heart rate, blood pressure, muscle tension, and skin temperature. One study found that biofeedback “appears be a useful approach to the treatment of myofascial pain disorder.”
Alternative Pain Treatment Directory founder and CEO Cindy Perlin, LCSW, who has MPS, reported that her own experience with biofeedback turned her life around. “After experiencing disabling back pain for over three years, I had a very dramatic turnaround in my pain after one visit. I was educated about the mind/body connection and coached in a biofeedback-assisted relaxation technique. My pain was reduced 50% in a day because I learned that I could have some control over my body and my pain. The fear of lack of control was greatly increasing my pain. I continued to practice the technique and was soon feeling well enough to return to a normal and productive life.”
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Conclusion
Myofascial pain syndrome is a common but often misdiagnosed cause of chronic pain. There are many natural, safe and effective treatments that can provide relief.
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