Myofascial Pain Overview

Myofascial pain is caused by abnormal stress on the muscles. It is a chronic condition that affects the fascia (connective tissue that covers the muscles). This pain syndrome can be confused with fibromyalgia and may also accompany it.

Unlike fibromyalgia, myofascial pain is associated with localized muscle pain or trigger points, while fibromyalgia is widespread pain in all four quadrants of the body (above and below the waist as well as on left and right sides) In addition, fibromyalgia is typically associated with non-restful sleep, fatigue, and often other somatic complaints including bladder, bowel, and central nervous system symptoms such as headaches, nerve pain, and cognitive issues.

Muscles Affected by Myofascial Pain

Other causes of myofascial pain include tension, spasm, or fatigue of the muscles that allow a person to chew, called the masticatory muscles. Grinding of the teeth and jaw clenching are related to myofascial pain and can lead to headaches.

It is common for myofascial pain to limit jaw movement and to affect muscles in the neck, back, and shoulder. Actually, this pain can affect any skeletal muscle in the body. It is not limited to the muscles of mastication (chewing).

Diagnosing Myofascial Pain

Your healthcare provider can diagnose myofascial pain after a physical examination reveals trigger points. Locating the trigger points is important to the diagnostician. X-rays are not helpful in diagnosing myofascial pain. Onset of myofascial pain can be acute following injury or chronic following poor posture or overuse of the muscles.

This is a common condition. Considering that 14.4% of the general U.S. population have chronic musculoskeletal pain, it has been estimated that 21% to 93% of patients complaining of regional pain actually have myofascial pain.

Treatment of Myofascial Pain

Myofascial pain is not considered fatal but it can significantly affect quality of life. Treatment is important and can include:

• Mouth guards to prevent clenching of teeth
• Splints, braces, or slings
• Medications including sleep aids, NSAIDs, Tylenol
• Local anesthetics
• Steroids
• Botox injections to relieve muscle spasm

Physical therapy, relaxation, and biofeedback can also be helpful modes of treatment for myofascial pain. Interestingly, even if untreated, most myofascial pain syndrome patients stop having symptoms in 2 or 3 years.

Distinguishing Myofascial Pain From Fibromyalgia

Fatigue and pain attributable to musculoskeletal (muscle and bone) disease is a leading cause of clinic visits across the world.

Fibromyalgia is a chronic or long-term musculoskeletal disorder that is characterized by tenderness, pain, and discomfort in specific body parts, or tender points. This pain leads to problems with sleeping as well as headache and fatigue. Fibromyalgia results in widespread pain, and experts suggest that fibromyalgia occurs because pain processing is abnormal in those with this condition. More specifically, results from research studies show that people with fibromyalgia have increased levels of glutamate in the central nervous system. Glutamate is an excitatory neurotransmitter, which apparently when present in increased levels is linked to the pain of fibromyalgia.

Great debate exists concerning whether myofascial pain is either a separate disease entity from fibromyalgia or a subtype of fibromyalgia. One specific difference between these two conditions is the presence of trigger points. In people with myofascial pain, palpation or touching certain specific points (also described as "taut bands") can cause a person to jump in pain. Of note, these trigger points are sometimes also caused "jump points."

Looking forward, more research needs to be done to fully elucidate the porous relationship between myofascial pain and fibromyalgia.