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Myofascial Pain syndrome (MPS) or Chronic Myofascial Pain (CMP)

Author: Disabled World

Original Publication Date: 2011-05-23

Synopsis and Key Points:

Information regarding Myofascial pain syndrome (MPS) or Chronic myofascial pain (CMP) a condition characterized by chronic and sometimes severe pain.

Main Digest

Myofascial pain syndrome (MPS), also known as Chronic myofascial pain (CMP), is a condition characterized by chronic and, in some cases, severe pain.

Myofascial pain syndrome is associated primarily with "trigger points", localized and sometimes extremely painful lumps or nodules in any of the body's muscles or connective tissue known as fascia.

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. There may be postural, emotional, and behavioral contributing factors.

MPS is often discussed alongside fibromyalgia. However, these two conditions are not the same, and neither is one exclusive of the other; patients may have either condition, or both. The primary difference between the two conditions is the pain's pattern. By accepted definition, fibromyalgia is associated with generalized pain, occurring above and below the waist and on both sides of the body. In contrast, MPS pain is localized, and may be detected by observing the myofascial trigger points in one or more specific area.

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 pain of myofascial pain syndrome centers around sensitive points in your muscles called trigger points. Myofascial pain caused by trigger points has been linked to many types of pain, including headaches, jaw pain, neck pain, low back pain, pelvic pain, and arm and leg pain. The trigger points can be painful when touched. And the pain can spread throughout the affected muscle.

In some cases, the area where a person experiences the pain may not be where the myofascial pain generator is located. This situation is known as referred pain.

Types of Trigger Points:

A latent trigger point is a dormant (inactive) area that has the potential to act like a trigger point.

A satellite myofascial point is a highly irritable spot in a muscle that becomes inactive because the muscle is in the region of another trigger pain.

A secondary trigger point is a highly irritable spot in a muscle that can become active due to a trigger point and muscular overload in another muscle.

An active trigger point is an area of extreme tenderness that usually lies within the skeletal muscle and which is associated with a local or regional pain.

Symptoms of Myofascial Pain:

Myofascial pain symptoms usually involve muscle pain with specific "trigger" or "tender" points. The pain can be made worse with activity or stress. In addition to the local or regional pain associated with myofascial pain syndrome, people with the disorder also can suffer from depression, fatigue and behavioral disturbances. Other symptoms include referred pain, restricted movement, and sleep disturbances.

Causes of Myofascial Pain:

Myofascial pain may develop from a muscle injury or from excessive strain on a particular muscle or muscle group, ligament or tendon.

Other causes include:

General fatigue

Repetitive motions

Injury to intervertebral disc

Lack of activity (such as a broken arm in a sling)

Medical conditions (including heart attack, stomach irritation)

Treatment options include physical therapy, trigger point injections or medications.

Massage therapy - Using Trigger Point release techniques may be effective in short-term pain relief. Physical therapy involving gentle stretching and exercise is useful for recovering full range of motion and coordination. Once the trigger points are gone, muscle strengthening exercise can begin, supporting long-term health of the local muscle system. Complementary therapy called myofascial release, using gentle fascia manipulation and massage, is believed by some to be beneficial and pain-relieving.

Drug categories used in the treatment of myofascial pain: anti-depressants (primarily SNRIs), calcium channel blockers such as Pregabalin (Lyrica), and musculoskeletal relaxants such as Baclofen.

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