What is myofascial pain syndrome and are trigger point injections an effective treatment method?
Myofascial pain has been described as muscle pain, a very simple and straightforward explanation. However, the fascia, where that pain actually originates, is proving to be anything but simple. There are organizations and conferences focused solely on gaining a better understanding of fascia and its role in how the body functions. According to The Fascia Research Society, “Fascia is the most pervasive, but perhaps least understood network of the human body. No longer considered the ‘scraps’ of cadaver dissections, fascia has now attracted the attention of scientists and clinicians alike.”
What we do know is that everything that lies beneath the skin is wrapped with an interconnected web of connective tissue that is called the fascia. This includes all of the organs, bones, blood vessels, nerves and muscles. It is the fascia that holds everything together, gives it structure and, at the same time, allows for movement.
The prefix “myo” refers to muscle, so myofascial pain syndrome (MPS) is a condition affecting the connective tissue (fascia) that surrounds and supports the muscles. It can be located in one particular muscle or it may be spread through a muscle group. MPS can result in the development of a trigger point, which is a knot that forms in a muscle due to injury or overuse. Pressure on the trigger point causes what is called “referred pain”, meaning that the pain and other effects, like tension and decreased range of motion, is felt in an entirely different part of the body.
Myofascial pain syndrome is not the only type of chronic condition that has trigger points. They are also found in those struggling with fibromyalgia and tension headaches.
Causes Of Myofascial Pain Syndrome
Some of the more common causes of myofascial pain syndrome include:
- Muscle injury or strain
- Stress, resulting in the continued, and usually unconscious, tightening or clenching of muscles
- Injury to vertebrae
- Fatigue, that is more than occasional
- Repetitive motion
- Reduced or restricted movement, for example, an arm in a sling for an extended length of time
Treating Myofascial Pain Syndrome
Anything with “pain” in its name is not a good thing, and myofascial pain syndrome is no exception. Besides the aching pain that radiates from deep in your muscles, MPS can reduce your range of motion and make it difficult for you to get a good night’s sleep. The good news is that there are treatment options that your healthcare professional can recommend.
Your doctor will start with more conservative methods. These will likely include some combination of:
- Over-the-counter pain and anti-inflammatory medications
- Muscle relaxers
- Physical therapy
- Massage, that focuses on soft tissue manipulation
- Complementary techniques, like acupuncture
Trigger point injections may be recommended in cases that are not responsive to these initial efforts. The process is done in your doctor’s office and only takes a few minutes. The injection, which typically contains a local anesthetic and at times can include a steroid, is done at the site of the trigger point. If there is more than one trigger point, several injections may be done at the same time. The trigger point injection deactivates the trigger point and alleviates the associated pain. It is the actual needling of the trigger point which is most therapeutic and not the medication injected. When anesthetic is utilized, its purpose is primarily to maintain comfort during the injection procedure.
Although not the same process, a dry-needle method can also be used to try and break up the knots causing the trigger points. This is done without anything being injected: only the needle itself is used to physically break apart the tissue. Myofascial treatments can also accompany complementary techniques such as acupuncture and cupping which are best offered in a comprehensive medical practice that combines both more traditional and alternative therapies.
If you have any questions regarding myofascial pain syndrome or trigger point injections, contact the experienced physicians and staff of Long Island Spine Rehabilitation Medicine today. We are committed to providing our patients with personalized, non-surgical treatments that treat the underlying cause of their symptoms.