Myofascial pain can be mild or debilitating and does not resolve on its own or with the application of ice, heat, or rest. While the exact causes of MPS are not fully understood, possible contributors include:
- Muscle overuse
- Muscle clenching/tensing
- Direct injury (strain, strain, break, twist, or tear)
- Direct trauma to the region
- Poor posture
- Sedentary lifestyle
- Emotional disturbances
- Certain systemic diseases
- Heavy lifting
- Vitamin deficiencies
Trigger Point Massage
Trigger point massage techniques are highly effective for short-term pain relief and for helping stretch and strengthen the local muscle system. Gentle fascia massage, otherwise known as myofascial release, can also help improve the condition.
The term “trigger point” was coined in 1942 by Dr. Janet Travell and refers to pain related to an irritable point in the skeletal muscle or fascia. Trigger points evoke not only local pain but can also refer pain to nearby tissues.
Myofascial Pain Syndrome: Types of Trigger Points
- Active Trigger Points: Active trigger points produce unrelenting, debilitating pain and can cause pain locally or nearby when pressed with a finger. The pain can also cause burning, numbness, fatigue, tearing, sweating, and dizziness. If untreated, the surrounding muscles may take up the slack, leading to the development of secondary trigger points. It is not unusual for chronic myofascial pain patients to have multiple referred pain patterns, making diagnosis and treatment more complex.
- Latent Trigger Points: Latent trigger points are common and can lie quietly in muscles for years. Unless you press the trigger point and feel the tenderness, you probably don’t know they are there. Latent trigger points may persist for years after apparent recovery from injury and can cause: restricted movement; distorted muscle movement patterns; stiffness and weakness of the affected muscle.
Note that latent trigger points can become active, such as an old injury that periodically resurfaces when aggravated by muscle overload, a cold draft, fatigue, infection, illness, or stress.
- Multiple Trigger Points: Prolonged referral of pain from one trigger point to another area of the body can cause other trigger points to develop. If left untreated, these too can activate and refer pain, creating multiple pain patterns.
Diagnosing Myofascial Pain Syndrome
Sometimes, the actual trigger points causing the pain are secondary to other sources of pain, such as arthritis or bulging discs. Hence, these conditions are referred to as “the great mimickers.”
To date, there are no commonly available lab tests or imaging studies that can confirm a diagnosis of myofascial pain syndrome or chronic myofascial pain. A skilled practitioner is trained to recognize the symptoms of MPS, and trigger points are diagnosed by examining signs, symptoms, pain patterns, and manual palpation.
Myofascial Pain and Trigger Point Massage
Trigger Point Pressure Release involves applying pressure with a finger or other instrument to the trigger point and increasing the pressure as the trigger point stretches, releases, and softens. Once trigger points are released, the muscle needs to be moved through its full range.
Returning to normal activities is accelerated by adhering to the self-care program given to you by your therapist, as well as by minimizing stress, pacing your activities, and avoiding overexertion.
Misdiagnosis of Chronic Pain
The misdiagnosis of pain is the most important issue taken up by Dr. Travell. Referred pain from trigger points mimics the symptoms of a very long list of common maladies, but doctors rarely consider the source to be myofascial. Yet Dr. Travell holds that most common everyday pain is caused by myofascial trigger points and that ignorance of this can lead to false diagnoses and failure to deal effectively with pain.
If you or someone you know are experiencing back, neck or shoulder pain, headaches, jaw pain, or a repetitive stress injury, you may be suffering from myofascial pain syndrome or chronic myofascial pain.