“Myofascial pain syndrome is a chronic pain disorder. In this condition, pressure on sensitive points in your muscles (trigger points) causes pain in the muscle and sometimes in seemingly unrelated parts of your body.”[i]
What Is Myofascial Tissue?
Myofascial tissue is thin, fibrous connective tissue that extends throughout your body to provide support and protection to your muscles, bones, and organ systems. Myofascial tissue fibers are made up of collagen and elastin fibers that are suspended in a fluid called ground substance. With a high tensile strength, it provides strong support for the muscles, while at the same time allowing for flexibility. You can think of myofascial tissue as being similar to spandex. It’s pliable and can expand and contract with your body movements. Healthy myofascial tissue is soft and relaxed; however, any injury or inflammation to the tissue can cause it to tighten, resulting in knots, adhesions, and pain in the tissue.
What Are the Causes and Symptoms of Myofascial Pain?
Myofascia weaves its way throughout the body in a pattern that is unique to each individual. Unlike the muscles of the body that have a predictable origin and insertion, the route that myofascia takes is determined by each individual’s physical and emotional stressors from early in life.
Our myofascial pattern is constantly changing. Physical stress in the form of illness, trauma, repetitive motion, surgery, lack of activity, or postural change can all cause constriction of the fascial system. However, emotional stressors such as hormonal changes, anxiety and depression, fatigue, and lack of sleep can also have the same effect on myofascial pain. Over time, this can result in abnormal pressure on the nerves, muscles, bones, or organs.
We are literally being squeezed from the inside, and numerous symptoms begin to emerge. We may experience pain, loss of motion, decreased energy, difficulty concentrating, and inability to relax and sleep in either a single muscle or an entire muscle group. The myofascia becomes very hard and sticky. It doesn’t allow proper distribution of fluid throughout the body.
Instead of being soft and pliable at rest, the soft tissue system begins to carry an abnormal amount of tension all the time. The muscles feel hard and firm, even when we are trying to relax. The body perceives a constant level of stress that it cannot let go.
This results in the following:
- Soft-tissue pain ranging from mild to severe
- Headaches and/or migraines
- Disturbed sleep
- Balance problems and/or dizziness
- Tinnitus (ringing in the ears) and ear pain
- Memory problems
- Unexplained sweating
- Worsening symptoms due to stress, changes/extremes in weather, and physical activity
- Numbness in the extremities
- Popping or clicking joints
- Limited range of motion in joints, especially the jaw
- Doubled or blurry vision
- Unexplained nausea
Are Fibromyalgia and Myofascial Pain the Same?
Pain and fatigue associated with the musculoskeletal system are among the leading causes of patients visiting their physicians, and nearly one-third of such patients suffer from fibromyalgia. Fibromyalgia syndrome (FMS) is a chronic debilitating disorder characterized by widespread pain with tenderness in specific areas, leading to fatigue, headache, and sleep disorder.
Myofascial pain syndrome (MPS) is also a localized musculoskeletal pain-producing condition. Though diagnostic and management criteria differ from FMS, it’s considered by many to be a subtype of FMS. To date, no exact cause has been held responsible for these painful conditions, so treatment of these disorders is always a challenge.
Is There a Cure?
Is there a cure to our daily habits, postures, and activities? I always tell my patients that their recovery has more to do with what happens outside my office than what happens inside it. If you can “undo” what I have “done” faster than I can “undo” your issues, then we are in for a long treatment plan!
Treatment options are vast. My recommendation is always as follows:
- “If you have a physical problem, then a physical treatment is likely a better option!”
- “If you have a chemical problem, then a chemical treatment may be a better option.”
As a general rule of thumb, I recommend starting with the least invasive treatment available and escalating the treatment to more invasive treatment methods as the conservative ones become ineffective or fail.
What Are the Differences Between MPS and FMS?
The symptoms associated with MPS and FMS—such as musculoskeletal pain, taut fibers, twitch response, referred pain, fatigue, poor sleep, paresthesia, headache, sensation of swelling, and irritable bowels—are more frequent and generalized with FMS. Conversely, they are typically less frequent and more localized with MPS. The one symptom that does not follow the general rule here is referred pain.
Can They Happen Together?
In my opinion, yes. If you have FMS, you have MPS!
What Are the Treatments for MPS and FMS?
Although there are many theories, no clear causative factors responsible for MPS and FMS have been isolated. Association of prolonged static postures, lack of exercise, high body mass index (BMI), sleep disturbance, and emotional stress have been found. The treatment recommended for these conditions is therefore multimodal in nature and can be categorized as pharmacological and/or non-pharmacological therapies.
For example, medications such as anti-inflammatory drugs, muscle relaxants, and analgesics can be used to ease the severity of the symptoms. Additionally, non-pharmacological methods such as trigger point injections, ultrasound therapy, yoga and exercise, ice and heat, anti-inflammatory creams, and massage therapy are often used. For longer lasting and maximal benefits, the present practice combines both the non-pharmacological approaches with the short-term pharmacological therapies.
What to Expect with an MPS Diagnosis
MPS can be an overwhelming condition to live with as it can affect your quality of life and interfere with physical activities that you previously enjoyed. Recognizing your symptoms early and seeking treatment can help you manage MPS successfully.
Understand that the same treatment may not work for everyone with MPS, so do not become discouraged. Like many conditions, you will experience good days and bad. Make sure you make healthy lifestyle choices and stay compliant with the treatment plan that your physician created for you.
Keep an eye out for future blogs in which we discuss specific treatments and types of providers to seek help for MPS and FMS.