woman talking with doctor about her myofascial pain syndrome diagnosis

Diagnosing Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic pain disorder rooted in the fascia. The fascia is a tissue that covers the muscles. Different from normal muscle pain, myofascial pain syndrome is characterized by muscle discomfort in a localized area that gets worse instead of better over time. Nonetheless, myofascial pain syndrome shares several characteristics with other pain disorders, such as fibromyalgia. Here’s a look at diagnosing myofascial pain syndrome. 

Physical Exam

When you see your doctor, he will need to perform a physical exam. Symptoms suggestive of myofascial pain syndrome include pain specific to a muscle or group of muscles. You may also experience difficulty sleeping because of the inability to get comfortable or may have experienced sleep deprivation leading up to the development of myofascial pain. Specifically, myofascial pain is often felt deep in the muscle. And while there may have been a specific spot -- the trigger point -- where trauma or strain originally occurred, that may not be where you feel the ache. This is a phenomenon referred to as “referred pain.” 

Trigger Points

Trigger points are the main diagnostic trick whilst investigating myofascial pain syndrome. During your physical exam, if your doctor suspects myofascial pain syndrome he or she will likely look for the trigger point. Your doctor may probe the affected area to see if there is a trigger point. Depending on exactly how and where your doctor touches the trigger point, your body may respond in specific ways, like a reflex. 

According to the Cleveland Clinic, there are four diagnostic aspects in regards to trigger points. Active trigger points are points that are very sore and deep within the muscle, but also cause referred pain to the muscle or group of muscles. Latent trigger points, on the other hand, are spots that are not painful, but could very possibly become so. A secondary trigger point has the potential to become active as the result of muscular overload. A satellite myofascial point is essentially an area that was a trigger point, but no longer acts as one because there is an additional trigger point in the area. 

Process of Elimination

Unfortunately, there is no specific “myofascial pain syndrome” test. There are a lot of reasons you can have muscle pain, and a lot of different things that cause it. You may be subjected to a barrage of different tests, from blood to imaging, as your doctor attempts to rule out alternative diagnoses. 

While infrared or liquid crystal thermography can be used to detect trigger points as evidenced by an increase in blood flow, there really is not an imaging test that can do much in the way of diagnostics beyond finding other sources of the presence of pain. 

Comorbid Conditions

It is important to confide any symptoms you may have been experiencing, even if they seem unrelated. For example, some patients experience depression before or while experiencing myofascial pain syndrome. Additionally, seemingly unrelated symptoms may help your doctor discover the underlying reason you have developed myofascial pain syndrome. Anemia, hypothyroidism, and hypoglycemia, among other diseases, all appear to have a connection with myofascial pain syndrome. While this is important for diagnosis, it’s also extremely important for treatment and prevention. 

Last Updated: November 15, 2016