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myofascial pain syndrome (MPS)
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Myofascial pain syndrome (MPS) is characterized by acute or chronic regional muscle pain associated with single or multiple restricted painful regions (trigger points) within muscle taut bands
- also associated with stiffness and local twitch response when stimulated
by digital pressure or during located needling generating local or referred
pain
- individuals who have regional pain present with a high prevalence of MPS
- studies carried out in pain management centers and clinics of different specialities have shown prevalence ranging from 30% to 93% in patients complaining of regionalized pain
- high prevalence of MPS in people in their mature years of maximum activity, and in women
- the trapezius, levator scapula, infra-spinatus, and scalenes are the
most frequently affected areas by MPS
- a number of causal factors associated with MPS have been suggested such
as:
- acute physical overload,
- deep pain impulse,
- emotional tension,
- postural habits,
- fatigue,
- hypovitaminosis,
- infections,
- physical inactivity,
- poor physical conditioning,
- repetitive musculoskeletal microtraumas and trauma
- diagnosis of MPS is based on
- exclusion of other causes of regional muscle pain
- identification of trigger points in the taut band through palpation
of sensible nodules, local twitch response and specific patterns of pain
referral associated with each trigger point
- treatment
- MPS treatment consists of trigger points inactivation, and breaks the vicious cycle of pain-spasm-pain
- also includes reassurance (patient education, self care and behaviour therapy), physiotherapy (ultrasound, megapulse, low-level laser therapy, heat exercises, biofeedback, spray and stretch technique), acupuncture, dry needling, injections of anaesthetic, drug therapy and combined treatments
- medicine used to treat MPS includes analgesics, non-steroidal anti-inflammatory drugs (NSAIDS), muscle relaxants and tricyclic antidepressants
For NICE guidance regarding management of chronic pain (pain that lasts for more than 3 months) then see linked item.
Reference:
- Ernberg M. The physiopathological mechanisms behind chronic myofacial pain. Lakartidningen 2002;99(32-33):3206-10.
- Esenyel M, Caglar N, Aldemir T. Treatment of Myofascial Pain. Lippincott Williams & Wilkins 2000;79(1):48-52
- Bron C, Wensing M, Franssen JL, Oostendorp RA. Treatment of myofascial trigger points in common shoulder disorders by physical therapy: a randomized controlled trial . BMC Musculoskeletal Disorders 2007;5(8):107
Last edited 04/2021 and last reviewed 04/2021
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