Myofascial Pain Syndrome
Myofascial Pain Syndrome (MPS) is characterised by the presence of myofascial trigger points (TrPs), which are tender, hypersensitive points in skeletal muscles contained within palpable taut bands. This pain pattern is usually similar from patient to patient and is typical of each muscle. In fact, a specialist in the treatment of myofascial pain can usually predict the location of active TrP’s from the patient’s symptoms, without even touching the patient. Such a TrP hurts whenever you use the involved muscle, e.g., driving, eating, and combing the hair. An active TrP causes symptoms even when the muscle is at rest. A latent TrP doesn’t hurt at all, unless you press it and you might not even know it’s there.
- TrPs typically cause muscle weakness, incoordination and dysfunction before they cause pain.
- poor grip strength,
- buckling knees,
- weak ankles,
- TrPs can compress blood vessels, lymph vessels and nerves, because these structures pass through the fascia (“the endless web”), leading to numbness, tingling, burning, electric shock like sensations, coldness, skin discolouration and swelling.
- Other associated symptoms may include stiffness, muscle tightness, muscle cramps, localised sweating, chest pain, dizziness, tinnitus, pelvic pain, diarrhea, nausea, goose bumps, runny nose/eyes, eye strain, jaw pain and headaches.
- Strenuous use of the involved muscle. Judging the precise movement that produces pain is one way of diagnosing Myofascial Pain Syndrome (MPS). This may indicate the muscle harbouring the TrP’s.
- Forcible, passive stretch of the muscle, e.g., traction, conventional stretching
- Sustained or repeated contraction of the involved muscle, e.g., while lifting weights or doing isometric or strengthening exercises
- Local pressure on the TrP’s, e.g., a vigorous massage
- Keeping the affected muscle immobile in a shortened position for a long time, e.g., after sitting in a fixed position, driving, sleeping, and by using neck collars, back belts/corsets and braces
- Sitting under the cold draft of the air conditioner or an open window
- Cold, damp weather
- Viral infections, sore throat, respiratory infections, etc.
- Chronic allergies, including food allergies
- Excessive, uncompensated emotional stress or psychological tension
- Sleep disturbances
- Nutritional deficiencies, especially folic acid and pyridoxine deficiency
- Smoking, caffeine, and alcohol
- Recurrent bouts of hypoglycemia
- Hyperuricaemia (high uric acid levels)
Myofascial TrP pain is decreased by the following modalities:
- Short period of rest.
- By slow, steady passive stretching of the involved muscles, with warm fermentation
- By application of moist heat on the TRP
- By short periods of light activity with movement (not by isometric contraction or strengthening exercises).
- Specific manual therapy or myotherapy: Trigger point pressure release, Myofascial release (MFR), Muscle Energy Techniques (MET) and Positional Release Techniques (PRT).
- Clinician administered Spray and stretch.