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About Myofascial Pain Syndrome

The name “myofascial pain syndrome” (MPS) comes from the combination of “myo”, which refers to muscle, and “fascial”, which refers to the fascia, the connective tissue that surrounds and supports the muscles.


MPS is a chronic condition that causes muscle pain and discomfort. It is characterized by the development of trigger points, which are localized areas of muscle spasm and tenderness that can cause pain and discomfort and can often be felt as a knot or a palpable bump in the muscle.

The pain associated with MPS can be felt in the affected muscle or can radiate to other areas of the body. It is often described as a deep, aching pain, and can be accompanied by muscle stiffness and restricted range of motion.

MPS can affect any muscle in the body, but it most commonly affects the neck, shoulders, back, and hips.

MPS is typically caused by overuse or repetitive strain injuries, but it can also be caused by trauma (for example, after car accident or work-related injury, or slip-and-fall injury), poor posture, or prolonged periods of inactivity. Treatment for MPS typically involves a combination of physical therapy, massage, and medication to manage pain and inflammation.

MPS can often be confused with other disorders due to the similarity in symptoms. Some of the conditions that may be mistaken for MPS include fibromyalgia, polymyalgia rheumatica, chronic fatigue syndrome, multiple sclerosis, and rheumatoid arthritis.

It is important to have a proper diagnosis to ensure appropriate treatment.


The prevalence of myofascial pain syndrome varies depending on the population studied and the diagnostic criteria used. According to some studies, MPS is a very common condition, affecting up to 85% of people with chronic pain (Dommerholt2011).

However, other studies suggest a lower prevalence, ranging from 30% to 40% of people with chronic pain (Gerwin2004).

MPS is more common in women than in men, and it tends to occur more frequently in middle-aged and older adults. It is also more common in people who engage in activities that require repetitive motions or who have poor posture.

While MPS can occur in any muscle, it is most commonly seen in the muscles of the neck, shoulders, back, and hips. It can occur as a primary condition or as a secondary symptom of another underlying condition, such as fibromyalgia, chronic fatigue syndrome, or arthritis.


The symptoms of myofascial pain syndrome typically involve muscle pain and tenderness, as well as the presence of trigger points in affected muscles.

Some of the common symptoms of MPS include:

Muscle pain: The pain associated with MPS is often described as a deep, aching sensation that can be severe and debilitating. The pain may be localized to a specific muscle or group of muscles, or it may be more diffuse.
Trigger points: These are areas of hypersensitivity in the muscles and surrounding fascia that can cause pain, tenderness, and a characteristic “knotty” or “ropy” feeling when palpated. Trigger points may also cause referred pain, which means that the pain is felt in another part of the body, often at a distance from the trigger point itself.
Stiffness: People with MPS may also experience stiffness in the affected muscles, which can limit the range of motion and make it difficult to move the affected body part.
Weakness: In some cases, MPS can cause weakness in the affected muscles, making it difficult to perform certain tasks or activities.
Fatigue: Chronic pain and muscle tension associated with MPS can also lead to fatigue and a general feeling of malaise.

It is important to note that the symptoms of MPS can vary widely from person to person, and may also change over time depending on a number of factors, including stress, physical activity, and other health conditions.

Causes of myofascial pain syndrome

The exact causes of myofascial pain syndrome are not fully understood, but there are several factors that are thought to contribute to the development of this condition.

Some of the potential causes and contributing factors of MPS include:

Muscle injury or overuse: One of the most common causes of MPS is muscle injury or overuse, which can lead to the formation of trigger points in the affected muscles. This can happen as a result of a single traumatic event, such as a sports injury or car accident, or as a result of repetitive strain or overuse, such as in the case of a repetitive motion injury or chronic postural stress.
Muscle imbalances and postural abnormalities: Muscular imbalances and postural abnormalities can also contribute to the development of MPS, as these factors can place excessive stress on certain muscles and cause them to become tight and painful. For example, poor posture, scoliosis, and other spinal conditions can cause imbalances in the muscles of the back, leading to the development of trigger points.
Emotional stress and psychological factors: Emotional stress and psychological factors can also play a role in the development of MPS, as stress can cause muscle tension and trigger points to form. Additionally, people with anxiety, depression, or other mental health conditions may be more prone to developing MPS.
Medical conditions: Certain medical conditions, such as fibromyalgia, chronic fatigue syndrome, and autoimmune disorders, can also increase the risk of developing MPS.
Nutritional deficiencies: Nutritional deficiencies, particularly in vitamins and minerals that are important for muscle function, can also contribute to the development of MPS.

It is important to note that the exact causes of MPS may vary from person to person, and in many cases, there may be multiple contributing factors.


MPS itself is not a life-threatening condition; however, if left untreated or unmanaged, MPS can lead to several complications, including:

Chronic pain: If MPS is not properly managed, it can lead to long-term pain and discomfort, which can significantly affect a person’s quality of life.
Decreased range of motion: MPS can cause stiffness and decreased range of motion in the affected muscles, making it difficult to perform daily activities.
Sleep disturbances: The pain and discomfort associated with MPS can interfere with a person’s sleep, leading to fatigue and other related complications.
Depression and anxiety: Chronic pain can also lead to depression, anxiety, and other mental health conditions if left untreated.
Reduced productivity: If MPS affects the muscles that are necessary for work or daily activities, it can lead to reduced productivity and absenteeism.


The diagnosis of myofascial pain syndrome (MPS) may involve the following methods:

Medical history: The healthcare provider will ask about the patient’s symptoms, medical history, and any factors that may have contributed to the development of MPS.
Physical examination: The healthcare provider will examine the patient to look for the characteristic signs of MPS, such as the presence of trigger points and taut bands of muscle fibers.
Manual palpation: The healthcare provider may use manual palpation to locate the trigger points and apply pressure to them to determine if it reproduces the patient’s pain.
Diagnostic injection: Sometimes, a diagnostic injection of a local anesthetic or saline solution may be used to confirm the diagnosis. If the injection temporarily relieves the patient’s pain, it suggests that the pain is due to MPS.
Imaging tests: Imaging tests such as X-rays, CT scans, and MRI scans are usually not helpful in diagnosing MPS, but they may be used to rule out other conditions that can cause similar symptoms.
Laboratory tests: Blood tests may be done to rule out other underlying medical conditions that can cause similar symptoms.

It is important to note that there is no single test or procedure that can definitively diagnose MPS. The diagnosis is often made based on a combination of the patient’s symptoms, physical examination, and ruling out other possible causes of the symptoms.

Common Trigger Points

The common trigger points that can be found in the muscles of people with MPS are:

Active trigger points: These are trigger points that are actively causing pain in the affected muscle. They are usually tender to the touch and can refer pain to other parts of the body.
Latent trigger points: These are trigger points that are present in the muscle but are not causing pain or other symptoms. They can become active trigger points if they are aggravated by injury, stress, or other factors.
Secondary trigger points: These are trigger points that develop in response to pain or dysfunction in another muscle. For example, if a person is compensating for a painful knee by walking with a limp, this can cause trigger points to develop in the muscles of the hip and lower back.
Satellite trigger points: These are trigger points that develop in a muscle that is located near another muscle with an active trigger point. For example, if a person has an active trigger point in their neck, they may develop satellite trigger points in the muscles of their shoulder and upper back.

Identifying the specific type of trigger point present in a person with MPS can help guide treatment and management strategies.

What do we do at WMC?

At the Wilderman Medical Clinic, we offer a variety of interventional and non-interventional pain management options, including:

Interventional pain management for myofascial pain syndrome:

Trigger point injections: These involve injecting a local anesthetic or saline solution into the trigger point, which can help relax the muscle and relieve pain. This can be effective for short-term relief of pain but may need to be repeated periodically.
Cortisone injections: These involve injecting a steroid medication into the trigger point, which can help reduce inflammation and pain. This can provide longer-term relief of symptoms but carries the risk of side effects associated with corticosteroid use.
Botox injections: These involve injecting botulinum toxin, the same medication used for cosmetic purposes, into the trigger point. This can help relax the muscle and reduce pain, but the effects may wear off after a few months and the injections may need to be repeated.
PRP injections: Platelet-rich plasma injections involve injecting components of a patient’s own blood into a targeted area in order to stimulate the body’s natural healing mechanisms. Recent studies on the efficacy of PRP injections for managing myofascial pain of the masseter muscles (Agarwal et al. &Nitecka-Buchtaet al.) indicate that, while further research is needed, PRP may be an effective treatment option for myofascial pain syndrome.

Non-interventional pain management for osteoarthritis of the thoracic facet joints:

• Psychotherapy
• Kinesiology education sessions

Overall, the choice of treatment will depend on the severity and location of the trigger points, as well as the individual patient’s medical history and preferences.

Other available treatments for myofascial pain syndrome include:

  • Physical therapy: This can include stretching, massage, and other techniques to help relax and lengthen the affected muscles.
  • Heat or cold therapy: Applying heat or cold to the affected area can help reduce pain and inflammation.
  • Acupuncture: This involves inserting thin needles into specific points on the body to help alleviate pain and promote healing.
  • Dry needling: This is a technique similar to acupuncture, but with a focus on targeting trigger points specifically.
  • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and other medications may be prescribed to help manage pain and other symptoms associated with MPS.
  • Stress management: Reducing stress levels can help alleviate MPS symptoms, as stress can often exacerbate muscle tension and trigger points.

Written by:

Niharika Mandal

Medically reviewed:

Dr. Igor Wilderman

Niharika Mandal has a PhD in Biotechnology and over four years of experience as a medical writer. Her expertise includes writing and editing clinical documents such as protocols, clinical study reports, patient narratives, and manuscripts, in compliance with regulatory guidelines. She has authored a book and published several articles in international journals in biotechnology. Niharika’s passion for healthcare is evident in her work, as she is dedicated to positively impacting people’s lives through her contributions to the medical field.

Works cited

Agarwal V, Gupta A, Singh H, Kamboj M, Popli H, Saroha S. Comparative Efficacy of Platelet-Rich Plasma and Dry Needling for Management of Trigger Points in Masseter Muscle in Myofascial Pain Syndrome Patients: A Randomized Controlled Trial. J Oral Facial Pain Headache. 2022 Summer;36(3-4):253–262. doi: 10.11607/ofph.3188. Epub 2022 Nov 28. PMID: 36445907.

Dommerholt J. Myofascial trigger points: an evidence-informed review. J Man ManipTher. 2011;19(3):125-161. doi: 10.1179/2042618611Y.0000000002.

Gerwin RD. Classification, epidemiology, and natural history of myofascial pain syndrome. Curr Pain Headache Rep. 2004;8(5):371-376.

Nitecka-Buchta A, Walczynska-Dragon K, Kempa WM, Baron S. Platelet-Rich Plasma Intramuscular Injections – Antinociceptive Therapy in Myofascial Pain Within Masseter Muscles in Temporomandibular Disorders Patients: A Pilot Study. Front Neurol. 2019 Mar 19;10:250. doi: 10.3389/fneur.2019.00250. PMID: 30941095; PMCID: PMC6433706.

Shah JP, Phillips TM, Danoff JV, Gerber LH. An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol (1985). 2005;99(6):1977-1984. doi: 10.1152/japplphysiol.00537.2005.

Gerwin RD, Dommerholt J. Treatment of myofascial pain syndrome. Phys Med Rehabil Clin N Am. 2011;22(1):1-21. doi: 10.1016/j.pmr.2010.10.002.

Myofascial pain syndrome. Mayo Clinic website. Published January 30, 2020. Accessed May 4, 2023.

Myofascial pain syndrome. Cleveland Clinic website. Published December 14, 2020. Accessed May 4, 2023.

Shah JP. Myofascial pain syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Accessed May 4, 2023. Available from:


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