5 Things You Need to Know About Myofascial Pain Syndrome

Are you wondering about myofascial syndrome, because you think you might have it, or have been diagnosed with it?

Here I summarize 5 things I think are worth knowing when you’re wondering about the evolution of this syndrome, and what to do about it.

♻️ Last update: December 26, 2024.
👩‍⚖️ Declaration of financial interests: none directly related to the subject. My complete declaration of financial interests is in the legal notice section.
Written by Nelly Darbois, physiotherapist and scientific editor

Examinations are mainly used to rule out other pathologies

Myofacial syndrome can be diagnosed simply by asking questions and examining yourself.

Here are the most common signs of myofascial syndrome, although other problems can also cause these symptoms:

• pain that is difficult to localize, sometimes generalized ;
• sensitivity disorders or ants ;
• tissue tension on palpation, in painful areas known as trigger points. You can feel a taut band within the muscles, whether superficial or deep.

Complementary examinations such as imaging (X-ray, MRI, etc.) or blood tests are sometimes carried out only to rule out other pathologies that may cause the same symptoms.

In 2017, a research team tried to establish a consensus for the diagnosis of a myofacial syndrome, by interviewing various professionals. Here’s what they came up with:

(…) at least two of the following criteria must be positive for the diagnosis: 1/ the presence of a taut band, 2/ a hypersensitive point and 3/ projected pain.

Pain projected from a myofascial trigger point provokes a variety of sensory sensations, including pain moving to a distant area, deep pain, dull pain, tingling or burning.

Source: Bordoni 2023

Here are the other health problems that examinations can rule out in order to retain the diagnosis of myofascial syndrome [Cao 2021]:

• fibromyalgia;
• polymyalgia rheumatica (polymyalgia rheumatica, pseudopolyarthritis rheumatica),
• chronic fatigue syndrome,
• polymyositis (dermatomyositis).

There are different types of myofascial syndrome

There are different ways of categorizing this syndrome, even if management remains broadly the same. According to :

• the main location of the pain: even if the pain is sometimes generalized, there is often one area that is more sensitive than another, especially in the acute phase;
• how long symptoms have lasted : just a few weeks (acute syndrome) or several months (chronic).

The most common locations are the cervical spine, shoulder and trapezius muscles, pelvic floor and perineum muscles, gluteals and obturator internus muscles.

In some people, the syndrome lasts only a few weeks.

If it’s only been a few days or weeks since you were diagnosed with myofascial syndrome, this information should reassure you: many people have their symptoms disappear within a few weeks, even without treatment.

No precise figures are available.

In the case of long-term chronic sufferers (i.e. probably the most severely affected), we have the following figures: the average duration of symptoms is 63 months(just under 3 years), with a range from 6 to 180 months (7.5 years).

Source : Tantanatip 2023

Having symptoms for a long time is not a sign of seriousness, even if it is annoying.

Having symptoms for a long time is not necessarily a sign of seriousness, although it can be annoying.

Many people with myofascial syndrome manage to continue working, enjoying their hobbies and even playing sports. It’s a meagre consolidation, I grant you, but it’s a reality: living with chronic pain can be tamed.

Some people become disabled as a result of myofascial syndrome. Others continue their lives as before, simply adapting their pace of life during periods when symptoms are stronger or more troublesome.

Several treatments are available for all types of syndrome

There are dozens of clinical trials evaluating the efficacy of proposed treatments for this syndrome, either in relation to each other, to the natural course or to a placebo.

Here is a non-exhaustive list, although none of them stands out significantly in terms of efficacy: their clinical efficacy has not been proven in this syndrome:

• adapt your level of physical activity to how you feel, with or without supervision (for example, with the help of a physiotherapist or doctor), encourage an active lifestyle that allows the secretion of hormones that naturally relieve pain => management that I personally prefer;
• taking anti-inflammatory drugs (NSAIDs) orally or applied to the skin, muscle relaxants (cyclobenzaprine, tizanidine), benzodiazepines (clonazepam, diazepam) or antidepressants;
• apply patches of lidocaine, an anaesthetic, tothe skin;
• botulinum toxin injections;
• practice relaxation and mindfulness meditation ;
• follow a cognitive behavioral therapy program ;
• ultrasound therapy, acupuncture, dryneedling, radiofrequency, ozone therapy => I’m less enthusiastic about these practices, which are based on less solid theoretical foundations;
• manual therapy by a physiotherapist, osteopath, chiropractor, etc.

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That’s all I wanted to say on the subject! Any questions or comments? See you in comments!