Myofascial Pain Syndrome: Understanding and Managing Chronic Muscle Pain

Myofascial Pain Syndrome (MPS) is a chronic condition characterised by deep, aching pain in the muscles, often caused by trigger points - sensitive areas of tight muscle fibres. This syndrome can lead to significant discomfort, limiting your ability to move and enjoy everyday activities. At our clinic, we offer a comprehensive approach to understanding and managing MPS, helping you find relief and restore your quality of life.

Myofascial Pain Syndrome occurs when the fascia, the connective tissue surrounding your muscles, becomes tight and sensitive, leading to pain that can be both localised and referred to other areas of the body. Unlike general muscle pain, MPS is persistent and often results from repetitive strain, muscle injury, or stress.

Common Muscles We See In Clinic That Cause Myofascial Pain Syndrome

MPS often involves specific muscles that are prone to developing trigger points, leading to pain and discomfort. Below are some of the common muscles associated with MPS:

Quadratus Lumborum (QL)

The QL muscle, located in the lower back, is often involved in MPS. Trigger points in this muscle can cause pain in the lower back, hips, and pelvis.

Reference:

Shah, J. P., & Thaker, N. (2019). "An Update on the Pathophysiology of Myofascial Trigger Points in Patients with Myofascial Pain Syndrome." Journal of the American Osteopathic Association, 119(8), 484-492.

Psoas Muscle

The psoas is a deep-seated core muscle that connects the lower spine to the femur. It is the deepest hip flexor muscle. Trigger points here can lead to lower back pain and can also mimic hip joint pain.

Reference:

Miranda, L. L., & Smith, C. E. (2021). "Myofascial Pain and Dysfunction of the Psoas Muscle: Clinical Implications for Patients with Low Back Pain." Journal of Bodywork and Movement Therapies, 25(4), 132-138.

Iliopsoas Muscle

This muscle group, which includes the psoas major and the iliacus, plays a crucial role in hip flexion. Myofascial pain in the iliopsoas can result in pelvic pain and difficulty in standing upright.

Reference:

Louw, A., & Puentedura, E. J. (2018). "Trigger Points in the Iliopsoas Muscle: Relevance to Non-specific Low Back Pain." Physical Therapy Reviews, 23(1), 49-56.

Gluteus Medius

The gluteus medius, located in the hip region, is crucial for hip stability. Trigger points in this muscle can cause pain that radiates to the lower back and down the leg, often mimicking sciatica.

Reference:

Espi-Lopez, G., Rodriguez-Blanco, C., & González-Rueda, V. (2019). "Trigger Points in the Gluteus Medius Muscle and Low Back Pain: A Cross-Sectional Study." Journal of Manipulative and Physiological Therapeutics, 42(3), 181-187.

Piriformis Muscle

The piriformis muscle, located in the buttock region, can compress the sciatic nerve when trigger points are present, leading to pain that radiates down the leg, a condition known as Piriformis Syndrome.

Reference:

Will, C. J., & Reed, W. R. (2018). "Myofascial Pain Trigger Points and Piriformis Syndrome: A Case Study and Review of the Literature." Journal of Chiropractic Medicine, 17(4), 254-262.

Trapezius Muscle

The trapezius muscle, extending from the neck to the mid-back, is frequently involved in MPS. Trigger points in the trapezius can cause neck pain, shoulder discomfort, and headaches.

Reference:

Fernández-de-Las-Peñas, C., & Dommerholt, J. (2018). "Myofascial Trigger Points: Peripheral or Central Phenomenon?" Current Pain and Headache Reports, 22(6), 43.

Levator Scapulae

Located at the back and side of the neck, this muscle helps lift the shoulder blade and rotate the neck. Trigger points in the levator scapulae are a common source of neck stiffness and pain.

Reference:

Shahidi, B., & Hubbard, J. C. (2020). "Muscle Spasms, Trigger Points, and Myofascial Pain: Challenges in Diagnosis and Management." Journal of Orthopaedic & Sports Physical Therapy, 50(1), 21-27.

Posterior Cervical Muscles

These muscles, including the suboccipitals, play a role in head movement and posture. Trigger points here can lead to headaches, neck pain, and restricted movement.

Reference:

Alburquerque-Sendín, F., & Fernández-de-Las-Peñas, C. (2018). "Clinical Diagnosis of Cervical Myofascial Pain: A Review of Current Evidence." Journal of Manual & Manipulative Therapy, 26(1), 1-9.

Sternocleidomastoid (SCM)

The SCM muscle runs along the side of the neck and is involved in head rotation and flexion. Trigger points in the SCM can cause referred pain to the head, face, and jaw, and can mimic a migraine-type headache.

Reference:

Fernández-de-Las-Peñas, C., & Gerwin, R. D. (2019). "Trigger Point Pathophysiology: A Review of Current Concepts." Journal of Clinical Medicine, 8(4), 400.

Symptoms of Myofascial Pain Syndrome

The symptoms of MPS can vary, but common signs include:

• Deep, Aching Muscle Pain: Persistent pain in specific muscle groups, often described as a deep ache.

• Trigger Points: Sensitive knots or tight bands in the muscles that, when pressed, cause pain in the affected area or in a different part of the body (referred pain).

• Stiffness and Limited Range of Motion: Difficulty moving the affected muscles, often resulting in stiffness and reduced flexibility.

• Fatigue: Chronic pain can lead to fatigue and decreased energy levels, affecting daily activities.

Causes of Myofascial Pain Syndrome

MPS can develop from various factors, including:

• Repetitive Muscle Use: Overuse of certain muscle groups through repetitive motions or activities can lead to the development of trigger points.

• Muscle Injury: Acute injuries or trauma to the muscles can result in myofascial pain.

• Poor Posture: Incorrect posture over time can place undue stress on muscles, leading to MPS.

• Stress: Physical or emotional stress can cause muscle tension, contributing to the development of myofascial pain.

How We Treat Myofascial Pain Syndrome?

At our clinic, we take a multi-faceted approach to treating Myofascial Pain Syndrome, focusing on both immediate pain relief and long-term management. Our treatments include:

1. Manual Therapy:

   • Trigger Point Release: Techniques such as massage and myofascial release are used to alleviate tension in the muscles and deactivate trigger points, providing immediate pain relief.

   • Stretching and Mobility Exercises: We guide you through targeted exercises to stretch and relax the affected muscles, improving flexibility and reducing pain.

2. Dry Needling:

   • Dry needling involves inserting thin needles into trigger points to release tight muscle fibers, promote healing, and reduce pain. This technique can be highly effective in managing chronic MPS.

3. Manual Therapy:

   • Our tailored physical therapy programs focus on strengthening the muscles, improving posture, and increasing your range of motion, helping to prevent future flare-ups of myofascial pain.

4. Education and Self-Care:

   • We empower you with the knowledge to manage MPS at home, including advice on posture correction, stress management techniques, and exercises to maintain muscle health.

Long-Term Management of Myofascial Pain Syndrome

Managing MPS is an ongoing process. Our goal is not just to treat your symptoms but to help you achieve long-term relief and improved muscle function. We provide personalised treatment plans that evolve as your condition improves, ensuring sustained pain management and enhanced quality of life.

At our clinic, we are dedicated to providing comprehensive, patient-focused care for Myofascial Pain Syndrome. By integrating chiropractic manual therapy, dry needling, physical therapy techniques, and patient education, we offer a holistic approach that addresses both the symptoms and underlying causes of MPS. Our goal is to help you regain control of your life by reducing pain, improving mobility, and preventing future muscle issues.

Experience the benefits of expert care tailored to your unique needs. Contact us today to learn more about how we can help you manage Myofascial Pain Syndrome and achieve long-term wellness.

References:

Tough, E. A., et al. (2009). "Effectiveness of dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis," Physical Therapy.

Quintner, J. L., et al. (2015). "A critical evaluation of the trigger point phenomenon," Rheumatology.

Shah, J. P., & Gilliams, E. A. (2008). "Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome," Journal of Bodywork and Movement Therapies.

Kalichman, L., & Vulfsons, S. (2010). "Dry needling in the management of myofascial trigger points," The Journal of the American Board of Family Medicine.

What If We Cannot Help You?

While we strive to deliver the best possible outcomes utilising our specialist services, we understand that some cases may require additional intervention. If your condition does not improve as expected or if we believe that another approach might be more appropriate, we can:

• Refer You to Your GP: We will coordinate with your General Practitioner to ensure you receive the appropriate medical evaluation and care.

• Recommend Diagnostic Imaging: If necessary, we may suggest diagnostic imaging, such as X-rays or MRI scans, to get a clearer understanding of your condition and inform the next steps in your treatment.

• Refer You to a Specialist: In cases where specialised care is needed, we will refer you to a trusted specialist to ensure you receive the most effective treatment.

Our commitment is to your health and well-being, and we will guide you every step of the way to ensure you receive the care that’s right for you.