If you are experiencing unexplained muscle pain or have already been diagnosed with myofascial pain syndrome, contact one of the five offices of Long Island Spine Rehabilitation Medicine where our specialty is nonsurgical pain management and restoration of function. Our physiatrists use both traditional and complementary medical treatments to reach our primary goal of returning you to a pain-free state. 

What is myofascial pain syndrome?

Myofascial pain is muscle pain that originates in the fascia, the web of connective tissue that wraps everything beneath the skin, including muscle tissue. Fascia holds all tissues together, both providing us with structural support and allowing for movement. 

Myofascial pain syndrome is defined by the development of trigger points, muscle knots that form when a muscle can’t relax. Patients are sometimes able to isolate trigger points by touch, feeling the muscle knots under their skin.

Pressure on trigger points causes “referred pain,” i.e. pain, tension, or decreased range of motion not at the trigger point itself but in an entirely different part of the body. Trigger points are also activated in other conditions such as fibromyalgia.

Causes of Myofascial Pain Syndrome

Myofascial pain syndrome has many possible causes, including:

  • Muscle injury in an accident or due to repetitive motion
  • Stress, resulting in clenching or tightening of muscles on an ongoing basis
  • Reduced or restricted movement (e.g. having a broken limb in a sling or cast)
  • Poor posture, overuse of muscles, leading to ongoing fatigue
  • Injury to vertebrae (bones of the spine)
  • Congenital abnormalities, such as one leg longer than the other
  • Anxiety or depression

It should be noted that the stress that results in clenching or tightening of muscles frequently occurs unconsciously. Since patients are unaware of it, they are unable to report it on their own. Thankfully, our experienced physiatrists are adept at recognizing its presence through physical examination.

Symptoms of Myofascial Pain Syndrome

Signs and symptoms of myofascial pain syndrome include:

  • Tender knots in a muscle
  • Deep, aching muscle pain that persists or worsens with movement
  • Stiffness or weakness in the affected muscle
  • Limited range of motion
  • Difficulty sleeping due to pain

Although everyone has muscle aches from time to time, if, in spite of home remedies, you have ongoing or intermittent muscle pain severe enough to interfere with your regular routine or with your sleep, you should definitely make an appointment with us. Ongoing pain is not only uncomfortable, interrupting concentration and pleasurable activities. It also has a negative impact on your long-term mental and physical health.


At Long Island Spine Rehabilitation Medicine, we have a well-deserved reputation for diagnostic excellence, always the first step in successful treatment. In order to diagnose myofascial pain syndrome we:

  • Visually examine you for postural abnormalities
  • Perform a physical exam in which the doctor applies gentle pressure to locate the tight muscle bands of the precise trigger points that cause pain or muscle twitches
  • Ask you detailed questions about when and how you experience pain, whether it improves or worsens with certain activities, and whether you have had a recent injury or been engaging in repetitive actions.

Although imaging tests like X-rays and MRIs have been used to diagnose myofascial pain syndrome in the past, our doctors find palpation during a physical exam more accurate as well as more convenient. Well-trained hands locate the abnormally hard nodules of muscle fiber that cause intense pain at the site and/or radiating or referred pain. Recent NIH studies have shown that innovative ultrasound devices are also helpful in visualizing the trigger points of myofascial pain syndrome.


Because of our commitment to addressing your pain and bringing you back to full functionality, we use a number of therapies, often in combination, to get you up and running as quickly as possible, including:

  • Over-the-counter pain and anti-inflammatory medications (NSAIDs)
  • Muscle relaxers to reduce tension and ease pressure
  • Customized physical therapy involving stretching, posture training, ice and heat
  • Acupuncture to alleviate pain and inflammation
  • Trigger point injections of local anesthetic and steroids
  • Dry needling in which just the needles without medication can alleviate pain

Trigger point injections have proven to be a very effective treatment option for myofascial pain syndrome. They are also relatively simple to administer and receive. The procedure takes only a few minutes though several injections may be required. There is no downtime involved. You will be able to return to your normal activities immediately, though you should avoid strenuous exercise for a few days. After-effects of pain or numbness, bruising, or dimpling at the site will resolve within hours or days.

As with most treatments, patients have varying reactions to trigger point injections. While some

patients experience almost immediate relief from pain and increased range of motion, others take a few weeks to feel positive results. When successful, trigger point injections can provide welcome relief for several months and may be repeated as needed at recommended intervals. 

Contact Our Myofascial Pain Syndrome Specialists Now

We are well aware that symptoms of myofascial pain syndrome detract from your quality of life and are fully committed to alleviating them. The sooner you contact our skilled, compassionate physiatrists, the sooner you can stop suffering and regain your sense of well-being.