Myofascial pain syndrome - causes, symptoms and treatment

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Myofascial pain syndrome is a spasmodic phenomenon that occurs in skeletal muscles and adjacent fasciae( connective membranes around muscle tissue performing a protective function).Myofascial pain is characterized by the presence of trigger points - painful seals in the muscle tissue, which are either in the active or in the passive state.
In the active phase, trigger points are the direct cause of myofascial pain.

Myofascial pain syndrome by localization

Pain syndrome in the fascia and muscles can be classified according to the localization region. Pain can occur in:

  • in the facial muscles and fascia;
  • in the dorsal muscles;
  • in the muscles of the limbs;
  • in the pelvic region;
  • in the chest and abdomen;

Most often, myofascial syndrome occurs in the facial and spinal muscles, affecting all parts of the spine - cervical, thoracic and lumbar.

Myofascial facial pain

Symptoms of myofascial pain syndrome in the facial area are:

  • painful sensations in the chewing muscles that arise when chewing food, talking, and sometimes in a calm state;
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  • limitation of the motor functions of the mandible, crunch in the mandibular joints;
  • spasmodic phenomena in the masticatory musculature;

The emergence of this syndrome is due to the habit of straining the facial muscles, restraining emotional manifestations. If a person often clenches his teeth, strains the muscles of the neck and jaw muscles, it can contribute to spasmodic phenomena in the muscle tissue and the appearance of trigger points that the doctor can detect when palpating.

Often patients with myofascial syndrome misdiagnose the etymology of pain and seek help from dentists, believing that the pain is due to the sensitivity of the teeth to temperature changes or the mechanical impact of the toothbrush. Often such patient is put one more incorrect diagnosis - arthritis of temporomandibular joints.

Vertebrogenic myofascial syndrome

This pain syndrome is located in the back, in its cervical, sternal and lumbar regions, as well as in the extremities.

Myofascial pains are not associated with inflammatory processes in the peripheral nerves, and arise from other causes, the most common of which is the osteochondrosis of the spine.

In addition to osteochondrosis, vertebrogenic pain syndromes can also be affected by:

  • hernia of the vertebral disc;
  • spondylosis;
  • spinal canal stenosis;
  • osteoporosis;
  • spine trauma;
  • rickets;
  • violation of posture;

Risk factors can also include the stress that arises from an incorrect distribution of the load on the muscles due to a uniform posture during work or sleep, as well as prolonged muscle tension during physical exertion, weight transfer, and supercooling.

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Symptoms of

The main symptom of myofascial syndrome is spasmodic pain in the muscle tissue and the presence of trigger points that promote the occurrence of a constant tension.

At the onset of the disease, there is one trigger point, subsequently, due to a mechanical imbalance in the muscles, additional satellite points appear.

In the future, a so-called "mirror phenomenon" may occur, caused by neuralgic phenomena, when pain occurs in the same segmental location on the other side of the body.

The intensity and nature of myofascial pains depend on the localization of the pain syndrome and the degree of its development. Often the pain extends well beyond trigger points.

Attempts to actively stretch a patient's muscle tissue lead to increased pain. Immediate impact on the active trigger point is manifested in the patient as a "jump symptom", which forces a person to literally jump from pain.

Reasons for

Osteochondrosis

Pathologies of vertebral discs contribute to irritation of the sinuverteral nerve, which innervates the structure of the spine.

The effect on the abovementioned nerve provokes reflex spasm of the near-vertebral and distant muscles.

Prolonged muscle tension leads to the formation of trigger points and the development of a stable myofascial syndrome.

Developmental anomalies

Congenital and acquired anomalies of the human body can have a direct effect on the development of this pain syndrome.

The risk factor is, for example, the difference in leg length exceeding 1 cm.

This anomaly can cause pain in the muscles of the foot, lower leg, knee and hip, as well as in the waist. Uneven load on muscle tissue provokes overexertion and the appearance of trigger points.

Prolonged immobilization of muscles

These reasons include:

  • Prolonged preservation of the same posture during sleep;
  • Wrong recovery therapy after fractures;
  • Uncomfortable clothing;
  • incorrect posture;
  • Pulling the muscles with backpack straps or straps of bags;
  • Inability to relax muscles after prolonged exercise;

Undercooling of muscles

The value has both local supercooling of a specific muscle area, and general supercooling of the body. Usually hypothermia affects the development of the pain syndrome, coupled with general overstrain and fatigue of the muscles.

Mental factors

Emotional stresses are often accompanied by excessive muscular tension, indicating the body's readiness for physical reactions. When the stressful condition stops, the muscles remain in tension for a long time.

Influence also has chronic stress, in which the muscle tension becomes constant. The person loses control over the ability to relax the muscles, he can change gait and motor stereotypes. There are so-called "psychomotor changes" that provoke pain syndromes.

Diseases of visceral organs and joints

Pain pulses from the internal organs and joints of bones cause a corresponding reaction in the body - protective muscular tension, designed to immobilize a diseased joint or create a "protective corset" around the affected organ. This muscle tension contributes to spasms and triggering of trigger points.

Overload of untrained muscles

This syndrome is more common for people of mental work. A prolonged physical load of untrained muscles( for example, while working in a suburban area) provokes their excessive stress. Stretching in unsuccessfully performed movements also contributes to the development of myofascial pain.

Contusion

Muscular injury can also contribute to the activation of triggers. Even after the primary symptoms of the injury disappear, the tension in the trigger points can stay for a long time.

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Diagnostics

The true cause of myofascial pain can only be clarified by a specialist in neurological diseases. The diagnosis is preceded by an external examination of the patient, a conversation with him about the possible causes of the onset of pain syndrome, palpation of the affected muscle sites. In difficult cases, especially with the facial localization of trigger points, a hardware examination is performed using:

  • electroneuromyography;
  • ultrasound;
  • magnetic resonance imaging of the head and cervical spine;
    radiography;
Diagnosis of myofascial manifestations with the help of palpation requires the doctor to own specific techniques for manual examination of the patient.

The aim is to identify trigger points for the purpose of subsequent therapeutic effects.

Treatment of

Treatment of myofascial pain syndrome is performed with the help of medications( anesthetics and antispasmodics);drugs are injected, in the form of ointments or tablets.

A short-term drug blockade of trigger points using Lidocaine and Novocaine is performed with pronounced pain syndromes.
In most cases, in the treatment of myofascial syndrome, it is advisable to use drugs for muscle relaxation.

In the treatment of the disease apply:

  • pharmacopuncture;
  • electrophoresis;
  • phonophoresis;
  • acupressure;

In addition, massage, exercise therapy, and consultations with a therapist and neurologist are prescribed. In order to eliminate depressions, which may be the cause and effect of myofascial syndrome, antidepressants and hypnotics are prescribed.

In the future, the recovering physician is recommended daily exercise and physical activity. A positive effect is given by autogenic training with the purpose of deep relaxation of muscles. The patient is recommended to make a correction of his lifestyle - avoid long, monotonous poses, rationally re-equip his workplace.

Forecast

With timely therapy, the prognosis is usually favorable. Significance is the age of the patient and his ability to move in the period of restorative therapy.

Prevention

To prevent disease, you must observe the hygiene of work, fully rest, watch your weight, sleep properly and properly distribute muscle loads. It is also necessary to treat illnesses of internal organs in time, wear comfortable clothes, avoid hypothermia, follow the correct posture while driving the car and working at the computer.

Video, which highlights the main causes of myofascial syndrome :

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