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What is myofascial pain?
Myofascial pain syndrome (MPS) is a chronic condition that affects the fascia (connective tissue that covers the muscles). It is characterised by pain and tenderness in specific areas known as trigger points. These trigger points can be sensitive to touch and can cause referred pain, meaning pain felt in other parts of the body not directly associated with the location of the trigger point. The pain from MPS can lead to a limited range of motion and weakness in the affected muscles.
What causes myofascial pain?
Myofascial pain is caused by muscle irritation, leading to the development of trigger points, which are sensitive areas in the muscles. Several factors can contribute to the development of myofascial pain, including:
- Muscle overuse or injury: repetitive motions or overuse of a muscle, as well as acute injuries, can lead to the formation of trigger points.
- Poor posture: chronic poor posture can strain muscles and fascia, which may lead to myofascial pain.
- Stress and tension: emotional stress and tension can cause individuals to clench their muscles, which can contribute to the formation of trigger points.
- Sedentary lifestyle: lack of activity can weaken muscles and lead to poor muscle tone, increasing the risk of myofascial pain.
- Direct trauma: a direct blow or sudden impact to a muscle can initiate the development of a trigger point.
- Nutritional deficiencies: lack of essential nutrients, such as a vitamin D deficiency, may contribute to muscle tension and dysfunction, which can result in myofascial pain.
In many cases, the precise cause of myofascial pain may not be clear, and it can be the result of a combination of factors.
What are the symptoms of myofascial pain?
Myofascial pain syndrome is characterised by several symptoms, with the most common being:
- Localised muscle pain: this pain is often described as a deep, aching sensation in the muscle, which may worsen with activity or stress.
- Trigger points: trigger points are sensitive spots in the muscle or fascia that are painful to touch and can produce pain in other areas when pressed. These spots can feel like knots or tight bands in the muscle.
- Referred pain: pain that is felt in areas of the body away from the actual location of the trigger point. For example, a trigger point in the back may cause pain in the shoulder.
- Muscle stiffness and tenderness: the affected muscles may feel tight and tender, and this stiffness can limit the range of motion.
- Fatigue and sleep disturbances: individuals with myofascial pain often experience fatigue, which may be due to the chronic nature of the pain and its interference with sleep.
- Restricted movement: the pain and stiffness associated with myofascial pain can lead to a decreased range of motion in the affected muscles and joints.
- Weakness in the affected muscle(s): prolonged myofascial pain can lead to muscle weakness or a sensation of muscle fatigue.
- Trigger points: this term describes a patient’s reaction (such as flinching or jumping) when a muscle is palpated.
These symptoms can interfere with daily activities and overall quality of life, which makes it important to seek proper diagnosis and treatment. The intensity of these symptoms can vary from person to person and may fluctuate based on activity level, stress, and other factors.
Who is at risk of myofascial pain in Singapore?
In Singapore, certain groups of people may be at higher risk of developing myofascial pain due to various factors. These include:
- Office workers: individuals who work in office environments and spend long hours at a desk are at risk due to prolonged sitting and computer use, which can contribute to poor posture and muscle strain.
- Manual labourers: people engaged in physical labour or jobs that require repetitive movements are at higher risk due to the increased likelihood of muscle overuse and injury.
- Athletes: athletes and individuals who participate in regular physical activities may be at risk due to the repetitive use and potential overexertion of certain muscle groups.
- Ageing population: older adults may be more susceptible to myofascial pain as muscles and fascia lose elasticity and strength, increasing the risk of injury and strain.
- Individuals with chronic stress: high levels of stress can lead to chronic muscle tension and the development of trigger points.
- People with poor ergonomic practices: individuals with poor ergonomic practices, such as using poorly designed workspaces or furniture that do not support proper posture, may be at increased risk.
- Individuals with previous musculoskeletal injuries: those who have had previous injuries may develop myofascial pain in response to changes in gait or posture that compensate for the injury.
The high-stress lifestyle and long working hours prevalent in many Singaporean industries can contribute to the development of myofascial pain. Awareness, preventive measures, and early intervention can help manage and reduce the risk of myofascial pain in these at-risk groups.
How is myofascial pain diagnosed?
Myofascial pain syndrome is primarily diagnosed through clinical evaluation, as no specific laboratory tests or imaging studies can definitively diagnose it. Here is how the diagnosis of myofascial pain is confirmed:
- Medical history: your pain specialist will begin with a detailed medical history, asking about the nature of the pain, its duration, any activities or incidents that may have triggered it, and how it affects daily life.
- Physical examination: a physical exam will be performed to look for areas of tenderness, muscle knots, or trigger points. During this exam, gentle pressure may be applied to the suspected areas to elicit muscle pain or twitch response.
- Identification of trigger points: diagnosis often involves identifying sensitive trigger points that produce the characteristic pattern of referred pain. When palpated, these trigger points can produce a specific pain response.
- Rule out other conditions: other tests may be conducted to rule out conditions that could cause similar symptoms, such as fibromyalgia, chronic fatigue syndrome, or neurological disorders.
- Evaluation of symptoms: the symptoms and their impact on your life are considered. Myofascial pain syndrome is often considered when localised pain is present, with no apparent cause, and when the pain persists or worsens with time.
What are the treatment options for myofascial pain in Singapore?
Treatment for myofascial pain typically involves a combination of therapies aimed at relieving pain, improving function, and addressing the underlying causes of the condition. Common treatment options for myofascial pain include:
- Physical therapy: this is often a cornerstone of treatment and may include stretching exercises, posture training, and strength exercises to improve muscle function and reduce the incidence of trigger points.
- Trigger point injections: trigger point injections involve injecting a local anaesthetic, sometimes combined with a corticosteroid, directly into the trigger points to relieve pain and reduce muscle tension.
- Massage therapy: therapeutic massage can help relax tight muscles, improve circulation, and ease the pain associated with trigger points.
- Medications: pain relievers, anti-inflammatory drugs, and muscle relaxants may be prescribed to alleviate pain and reduce muscle tension.
Frequently asked questions
Myofascial pain can improve over time, especially with early intervention, but it may not completely resolve without treatment. Management usually requires a combination of therapies.
Myofascial pain syndrome can be chronic, especially if not properly treated. However, with appropriate management, individuals can often maintain a good quality of life and manage symptoms effectively.
While both involve muscle pain and tenderness, myofascial pain is localised to specific trigger points. In contrast, fibromyalgia is characterised by widespread body pain and additional symptoms like fatigue and sleep disturbances.
Prevention includes maintaining good posture, regular exercise, stress management, and addressing any ergonomic issues in the workplace or daily activities to reduce muscle strain and overuse.
Total Pain Specialist