Myofascial Pain Syndrome (MPS) is a term I came across in 2017, when a physiotherapist finally explained that this is what was causing my severe neck issues. In this post we go through what it is, examine if it’s part of Fibromyalgia, and my at-home treatments.
Definition of Myofascial Pain Syndrome
A good definition of Myofascial Pain Syndrome that I have come across explains it as: “hyper irritable spots, usually within a taut band of skeletal muscle or in the muscle’s fascia that is painful on compression and can give rise to characteristic referred pain, tenderness, and autonomic phenomena” 1
Are Trigger Points Part of Fibromyalgia?
There is often confusion between the tender points characteristic of Fibromyalgia and trigger points. This article discusses the differences and similarities and provides a chart for distinguishing between the two.
The propensity for medical professionals to throw every symptom into the Fibromyalgia basket set me back for a decade. If they had realised prior to 2017 that my neck pain was really caused by trigger points, then we could have begun working on them sooner. These tiny hyper irritable spots have caused me over ten years of sleepless nights and 24/7 pain that nothing completely relieved.
Whether or not one wants to accept trigger points as part of Fibromyalgia or separate, research has noted that where trigger points are present in those with Fibromyalgia, the treatment of trigger points relieves the Fibromyalgia symptoms associated – such as pain in that area and fatigue.
Diagnostic Criteria for Myofascial Pain Syndrome
MPS does not have universally accepted diagnostic criteria, so it also does not have reliable statistics as to the prevalence. An estimate, using data around musculoskeletal pain in general puts estimates of myofascial pain as a patient’s primary complaint at 30%. 2
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Causes or Contributing Factors for Trigger Points
- Fibromyalgia or other conditions, especially inflammatory ones
- Sleep deprivation
- Postural (including bad ergonomics at the computer)
- Trauma to the area
- Excessive or lack of exercise
- Emotional stress
- Nutritional deficiencies
- Excess weight
Treatment for Trigger Points
The above quoted literature review (2) discusses general treatments for MPS: aside from eliminating as many aggravators of the condition as possible (like proper ergonomic posture at computers), treating any other present diseases, the treatment usually includes NSAIDS (usually stated as unhelpful for Fibromyalgia), heat pack, and acupuncture applied by a specific methodology.
In my case, I found that placing acupuncture needles into the trigger point (gently, without aiming for muscle reactions like in dry needling) and leaving them in for 10-15 minutes followed by neck mobilisations and tractions, provides the best relief I have found. By going to a physiotherapist to do this every three weeks, in addition to my home treatment plan, is the best way to treat the trigger points. But they always come back. We have made some progress over the past year, but they are always there and re-triggered rather easily.
Whatever may work for you, it is likely to be multi modal – involving a few treatment options, including pharmacologic and alternative approaches.
My At-home Treatments for Trigger Points:
- Heat: heat pack, hot bath or shower
- Topical creams: Essential oil blended pain cream, Deep Heat
- Trigger Point Massager cane for self-trigger point activation (you can use your fingers or thumbs but mine get too sore for the level of pressure needed)
- Limiting computer time and using good ergonomic set up
- Medicines: Brufen, when they get to spasm level then a muscle relaxant
Your turn: Do you have trigger points too? How do you treat them?
- Travell, JG, Simons, DG. Myofascial Pain and Dysfunction. The Trigger Point Manual: Upper Half of Body, 2nd edition. Lippincott, Williams & Wilkins, Baltimore 1988.
- Overview of soft tissue rheumatic disorders Author:Irving Kushner, MDSection Editor:Zacharia Isaac, MDDeputy Editor:Monica Ramirez Curtis, MD, MPH Literature review current through: Mar 2018. | This topic last updated: May 12, 2017. on UptoDate.com
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