Myofascial pain syndrome is a chronic pain condition that affects the muscles and the surrounding connective tissue, called fascia. Myofascial pain syndrome causes certain points within these muscles, known as trigger points, to become hypersensitive and taught. These trigger points can cause not only localized discomfort but also radiate pain to other parts of the body.

Myofascial pain can be described as a persistent, deep, and often achy pain that may feel like knots or tight bands in your muscles. Understanding your condition is the first step in finding myofascial pain relief and regaining control of your life.

The top symptom of myofascial pain syndrome is localized muscle pain. Another defining characteristic of the condition is the trigger points. These appear as tender knots or nodules within the affected muscle. Pressure on trigger points can exacerbate the pain.

Additional signs of myofascial pain syndrome include:

• Pain radiating to other areas of the body
• Stiffness in the affected muscle group
• Muscle weakness
• Fatigue, caused by chronic muscle pain and discomfort
• Sleep disturbances, leading to insomnia and or restless sleep
• Headaches
• Joint pain, as myofascial pain syndrome, can mimic the symptoms of musculoskeletal conditions

Myofascial back pain stems from damage to the fascia. The fascia is the robust connective tissue encompassing your muscles and organs. When the fascia becomes inflexible and tense, trigger points are formed, and you may feel pain anytime these muscles contract. Trigger points can occur as a result of various factors, including:

• Muscle overuse: Repeating the same motion or activity frequently, like typing or lifting heavy objects, can strain your muscles and lead to the development of trigger points
• Muscle injury: As your muscles try to heal from injury, trigger points can develop
• Poor posture: Bad posture for an extended period can strain certain muscle groups and cause trigger points to develop
• Stress: Emotional or physical stress can cause muscle tension, which increases the likelihood of trigger points forming.
• Medical conditions: A medical condition like fibromyalgia can make you more susceptible to myofascial pain syndrome

Diagnosing myofascial pain syndrome can be challenging. Myofascial back pain, which is a main symptom of the condition, can similarly be a symptom of various spine conditions, like a pinched nerve.

At Gottlieb Spine, we will conduct a thorough evaluation to determine the specific location of your trigger point before recommending the appropriate myofascial pain treatment. Before making a diagnosis, your surgeon will perform a physical examination. This may be complemented by tests such as electromyography, ultrasound, and magnetic resonance elastography.

Additionally, your doctor may suggest further tests to identify the root causes of your discomfort, such as checking hormone levels for hypothyroidism, blood tests for iron deficiency, tests to rule out deficiencies in vitamins D or B12, as well as tests for yeast or bacterial infections or a blood test for hypoglycemia.

Myofascial pain syndrome is often mistaken for fibromyalgia, as they share similar symptoms. However, myofascial pain primarily involves localized trigger points, while fibromyalgia is characterized by multiple generalized trigger points. Additionally, myofascial pain sufferers experience referred pain more frequently than fibromyalgia patients.

Other symptoms that are more common in fibromyalgia, and less prevalent in myofascial pain syndrome include:

• Fatigue
• Poor sleep
• Burning, prickling, or tingling sensations
• Headaches
• Irritable bowels
• Swelling sensations

The goal of myofascial pain syndrome treatment is to alleviate your trigger points. To start, your doctor may suggest lifestyle changes and conservative techniques, such as:

• Making dietary changes
• Seeing a myofascial pain therapy specialist or physical therapist to learn stretching exercises for pain relief
• Practicing proper posture while sitting and standing
• Undergoing dry needling, which involves the insertion of thin needles into the painful area
• Receiving trigger point injections, where a numbing agent is injected by a pain specialist to alleviate muscle tension
• Trying electrical stimulation, which contracts the affected muscle rapidly to promote relaxation
• Considering a spinal cord stimulator, which employs low-level electrical signals targeted at the painful area

While spine surgery is not the main course of treatment for myofascial pain syndrome, it may be recommended if myofascial pain is associated with another underlying condition, like nerve compression or structural abnormalities in the spine.

For example, if your myofascial pain syndrome is causing compression of a nerve due to severe muscle tightness, decompression surgery may be needed to release the pressure on the nerve. However, this would be a secondary consideration after conservative treatments have been exhausted and the specific cause of the nerve compression has been identified.

Finding relief from myofascial pain syndrome is crucial for regaining control of your life. At Gottlieb Spine, we specialize in understanding and treating this complex condition. Our team of experts, led by Dr. Jamie Gottlieb, is dedicated to providing you with the most effective myofascial pain treatment options available.