Myofascial pain refers to painful muscles and surrounding soft tissue covering in a specific body area. It can have an acute presentation in the setting of soft tissue trauma (muscle strain) or it could become a chronic condition as a result of poor posture, stressful and physically demanding jobs, inactivity and sedentary lifestyle, spinal deformity, desk jobs with poor desk /chair ergonomic, non-supportive pillows, large breast size, kyphotic or scoliotic spine and excessive spinal curvature. In the chronic setting, Myofascial pain may be associates with other conditions like depression requiring additional treatment.
Myofascial pain involves either an individual or several muscles groups in a region. Often described by patients as “muscle knots,” the areas of significant focal tenderness known as “trigger points” are palpable by experienced examiners and is a target of treatment. Although a regional pain condition, Myofascial pain can have a referral pattern to involve adjacent body areas (example myofascial neck pain with associated headaches or scapular pain).
Myofascial pain diagnosed clinically by your treating physician and requires no diagnostic testing beyond a comprehensive physical examination. As with many other skeletal conditions, simple steps including the use of over the counter anti-inflamatories and topical cream (Bengay, Icy Hot), prescribed muscle relaxants, ice or heat packs, therapeutic message, routine stretching and aerobic exercises can dramatically improve the symptoms .
Supervised physical therapy program combined with ergonomic changes (chairs, computer desk, mattress, pillows) should be considered in early stages of treatment. Physical therapists may also use techniques like spray and stretching, myofacial release, acupressure, dry needeling, tens treatment, ultrasound treatment to complement the exercises program. Your treating physician at Tufts Medical Center in Boston may also consider Trigger Point injection treatment as an additional treatment options.
It is important to distinguish between a regional painful muscle in “Myofascial pain” and a condition called Fibromyalgia which is a rheumatologic disorder characterized by widely spread , multi-region painful soft tissue disorder which has its unique treatment. Your treating physician at Tufts MC in Boston would be able to differentiate between these two conditions.
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