Myofascial pain

Myofascial pain syndrome (MPS) is a condition characterized by chronic and, in some cases, severe pain. It is associated with and caused by "trigger points" (TrPs), which are localized and sometimes extremely painful contractures ("knots") found in any skeletal muscle of the body. The symptoms can range from referred pain through myofascial trigger points to specific pains in other areas of the body.

MPS may be related to a closer-studied complex condition known as fibromyalgia. By accepted definition, the pain of fibromyalgia is generalized, occurring above and below the waist and on both sides of the body. On the other hand, myofascial pain is more often described as occurring in a more limited area of the body, for example, only around the shoulder and neck, and on only one side of the body.

Neither MPS nor fibromyalgia is thought to be an inflammatory or degenerative condition, and the best evidence suggests that the problem is one of an altered pain threshold, with more pain reported for a given amount of painful stimuli. This altered pain threshold can be manifest as increased muscle tenderness, especially in the certain areas, e.g., the trapezius muscle. These syndromes tend to occur more often in women than in men, and the pain may be associated with fatigue and sleep disturbances.

The precise cause of MPS is not fully understood and is undergoing research in several medical fields but there are some systemic disorders, such as connective tissue disease, that can cause MPS. Unfortunately, many practitioners consider it too generalized and, since physicians' specializations have become so narrow, they do not want, nor have the necessary current information, to treat the condition.

A new form of therapy called myofascial release, using gentle fascia manipulation and massage, is believed by some to be beneficial and pain-relieving.

Myofascial pain syndromes can arise of distinct, isolated areas of the body, an example being urologic chronic pelvic pain syndromes (UCPPS). People who suffer from this syndrome are many times in "unbearable" pain which moves at will from one point in the body to the next. It has been found that mild pressure on "trigger point" areas may relieve some of the discomfort by calming down the nerve pain.

Relieving Myofascial Pain
Three different categories are effective in the treatment of myofascial pain. 1) Anti-depressants: Primarily SNRI's 2) Calcium channel blockers: Pregabalin (Lyrica) 3) Musculo-Skeletal relaxants: Baclofen