Myofascial Pain Syndrome (MPS)

Myofascial Pain Syndrome (MPS)

Myofascial Pain Syndrome (MPS) is a condition characterized by the presence of trigger points, which are hyperirritable nodules or knots found in skeletal muscles. These trigger points can cause local or referred pain, as well as other symptoms such as muscle stiffness, weakness, and limited range of motion.

MPS can affect any skeletal muscle in the body, but it is commonly found in the neck, shoulders, upper back, and lower back. It can also occur in the extremities, such as the arms and legs. In addition to pain, MPS can cause referred pain, which means that the pain is felt in a different area of the body than where the trigger point is located. For example, a trigger point in the neck may cause pain that radiates to the head, causing headaches.

Causes

The actual cause of Myofascial Pain Syndrome (MPS) is not yet fully understood. However, certain factors can increase your risk of developing Myofascial Pain such as –

• Muscle injury
• Muscle pain/strain with the repetitive movement of muscles
• Muscle weakness
• Poor posture
• Emotional stress leads to muscle tension
• Pinched nerve
• Working or Living in a cold environment

Other risk factors that may significantly contribute to the development of Myofascial Pain include –

• Vitamin deficiencies of Vitamin D and folate
• Metabolic and thyroid-related diseases
• Chronic infection problems

Symptoms

The symptoms of Myofascial Pain are different for each person. The pain can sometimes happen suddenly or at once also known as “flare-up” syndrome. It can also cause continuous dull pain that triggers in the background. The most common symptoms of Myofascial Pain Syndrome (MPS) usually noticeable are –

1. Localized or regional pain – The primary symptom of MPS is pain, which is usually localized to specific areas of the body. It can be described as a deep ache, tightness, or a burning sensation. The pain is often felt in the muscles themselves and may be constant or intermittent.
2. Trigger points – Trigger points are tender nodules or knots within the muscles that can be felt under the skin. These points are often sensitive to pressure and can cause referred pain in other areas of the body when stimulated.
3. Referred pain – Trigger points in MPS can cause pain to be felt in areas away from the actual site of the trigger point. This is known as referred pain. For example, a trigger point in the neck may cause pain that radiates to the head, causing headaches.
4. Muscle stiffness and tightness – People with MPS may experience muscle stiffness and a sensation of tightness in the affected muscles. This can lead to a reduced range of motion and difficulty with movement.
5. Muscle weakness – MPS can cause muscle weakness in the affected area. This weakness may be mild or more severe, depending on the extent of the muscle involvement.
6. Restricted mobility – Due to pain, stiffness, and muscle weakness, individuals with MPS may experience a limited range of motion and difficulty with certain movements or activities.
7. Fatigue – Chronic pain and muscle dysfunction in MPS can contribute to a sense of fatigue and decreased energy levels.
8. Sleep disturbances – MPS can disrupt sleep patterns due to pain and discomfort, making it difficult to get restful sleep.

These symptoms can overlap with other conditions, so a proper diagnosis from a healthcare professional is crucial. Additionally, the severity and specific symptoms can vary widely among individuals with MPS.

Diagnosis and Tests

Myofascial Pain Syndrome (MPS) is a condition characterized by the presence of trigger points, which are hyperirritable spots within taut bands of skeletal muscles. While there are no specific diagnostic tests that can definitively confirm MPS, healthcare professionals rely on a combination of clinical evaluation, patient history, and physical examination to make a diagnosis. Here are some commonly used methods to help diagnose MPS –

1. Medical History – Your healthcare provider will begin by discussing your symptoms and medical history. They will ask about the location, intensity, duration, and character of your pain, as well as any factors that may aggravate or alleviate it. They may also inquire about any previous injuries, surgeries, or underlying medical conditions that could contribute to your symptoms.
2. Physical Examination – A thorough physical examination is crucial in diagnosing MPS. The healthcare provider will palpate and examine the affected muscles, searching for the presence of trigger points. They will look for areas of muscle tenderness, taut bands, and reproduction of your pain when pressing on specific trigger points.
3. Trigger Point Identification – Trigger points are key diagnostic indicators of MPS. These are localized areas of muscle fibers that are hyperirritable and often feel like knots or nodules under the skin. The healthcare provider will carefully locate and evaluate the presence of trigger points, noting their location, size, tenderness, and the referred pain pattern they may cause.
4. Manual Muscle Testing – To assess the strength and functionality of the affected muscles, manual muscle testing may be performed. This involves applying resistance while you perform specific movements or actions to evaluate muscle weakness or dysfunction.
5. Imaging Studies – Although not specific to MPS, imaging studies like X-rays, ultrasound, or MRI scans may be ordered to rule out other potential causes of your pain. These imaging techniques can help identify structural abnormalities, such as bone fractures, joint disorders, or soft tissue injuries.

MPS diagnosis relies heavily on clinical judgment and the exclusion of other conditions with similar symptoms. Therefore, it’s essential to consult with a healthcare professional, such as a physician or a physical therapist, who can perform a comprehensive evaluation and make an accurate diagnosis based on your specific symptoms and medical history.

Treatment

If you are experiencing Myofascial Pain Syndrome then you may notice certain symptoms. It is necessary to consult your healthcare professional for successful treatment of the condition. The common treatments available to manage your pain and restoration of muscles are –

1. Medications

There are several medications that can be effective in providing relief for MPS such as –

• Non-steroidal anti-inflammatory drugs (NSAIDs) – Over-the-counter drugs such as acetaminophen (Tylenol) and ibuprofen (Advil) can reduce pain and swelling of muscles.
• Muscle relaxants – Benzodiazepines and tizanidine (Zanaflex) can reduce muscle spasms.
• Anticonvulsants – Gabapentin (Neurontin) and pregabalin (Lyrica) can relieve pain and muscle spasms.
• Botox injections – Botulinum type A prevents muscle contractions and may have pain-relieving effects.
• Tricyclic antidepressants – It treats several diseases and conditions such as fibromyalgia, chronic pain, and nerve pain.

2. Therapy

A physical therapist can plan your treatment based on the signs and symptoms of the condition in an individual. The most common therapies for pain relief include –

• Ultrasound – It uses sound waves to increase circulation and warmth in muscles. 
• Massage – It may massage your muscles to relieve pain. Physical therapist place pressure on the area with hand strokes to release tension.
• Posture training – It can help relieve pain by strengthening of muscles, especially in the neck and shoulder area. 
• Stretching – A gentle stretching exercise will help to relieve pain in the muscles. If you experience a sudden trigger point pain then your therapist may spray a numbing solution on the affected area.
• Heat application – Applying heat or hot packs in the area can reduce tension and muscle spasms.

3. Needle procedures

Applying numbing agent to the trigger point can help relieve pain. It may also involve a dry needling procedure in which a needle is directly inserted into the affected area. These help in breaking up muscle tension in and around the trigger point area. Acupuncture can also be an effective treatment in providing pain relief by stimulating of sensory nerves in the body.

Outlook

In general, every individual has varied levels of complexity and severity based on the patient’s condition. With appropriate treatment and self-care, many individuals with MPS can experience a significant reduction in symptoms and an improvement in their quality of life. However, it is important to note that MPS can be a chronic condition, and some individuals may experience periodic flare-ups or persistent symptoms despite treatment. 

Managing expectations and adopting a long-term management approach can help individuals cope with the condition and minimize its impact on their daily lives.