Myofascial pain syndrome is a chronic pain disorder. Generally, the pain is localized, occurring only in one muscle or a group of muscle. Physical therapy is often an effective treatment plan, once a diagnosis has been appropriately made. Here are 10 terms to help you understand your myofascial pain syndrome diagnosis.
- Fascia: While “myo” refers to the musculature system, “fascial” references the fascia. The fascia is an encompassing weblike structure that covers not only the muscles, but also the major organs. When the fascia is injured, it becomes rigid instead of flexible, making movement and comfort difficult.
- Active Trigger Point: One of the key characteristics of myofascial pain syndrome is the presence of a trigger point. When injury occurs to the muscle and/or fascia, whether because of trauma, strain, or overuse, it usually occurs in a particular spot. This spot becomes a bunched up knot of muscle fibers, and when pressure hits it, it sends pain to the muscle or muscle group in which it is present.
- Latent Trigger Point: According to the Cleveland Clinic, more than one type of trigger point may be present. A latent trigger point refers to this area of bunched muscles so sensitive to pressure. However, it no longer acts as an active trigger point, although it could still become one.
- Secondary Trigger Point: A secondary trigger point is exactly what it sounds like. Essentially, when you have a trigger point in one muscle, another active trigger point can develop in a different muscle. The secondary trigger point is a spot in this different muscle that is very irritated and could become an active trigger point due to the combination of the original active trigger point and additional strain in the second muscle.
- Satellite Myofascial Point: A satellite myofascial point is a combination of the latent and secondary trigger points. It is an uncomfortable knot in a muscle that no longer acts as a trigger point. However, the satellite myofascial point specifically loses its activeness because another trigger point forms to encompass the territory originally belonging to what is now a satellite point.
- Referred Pain: Referred pain is the phenomenon that occurs as a result of an active trigger point. Again, myofascial pain is generally quite localized. However, the actual spot of discomfort (trigger point) is not the only place where the pain occurs. Referred pain is the sensation of pain that spreads across the muscle or muscle group as a result of the trigger point.
- Infrared/Liquid Crystal Thermography: One of the reasons myofascial pain syndrome is so difficult to diagnose is because it doesn’t show up on most imaging tests; they are usually used only to rule out other disorders or reasons for pain. This is likely because the fascia doesn’t show up in imaging tests. The only test available for diagnosing myofascial pain syndrome is infrared or liquid crystal thermography, which shows temperature change, thus allowing your medical team to note areas where there is extra blood flow, indicating a trigger point.
- Trigger Point Injection: While physical therapy is generally the best option for treating myofascial pain syndrome, some people may need additional sources of treatment to help with the pain. One of the most effective methods is a trigger point injection. In this procedure, an injection of anesthesia is given straight into the trigger point.
- Dry Needling: In some cases, the anesthesia isn’t even necessary. Dry needling involves simply injecting the needle into and near the trigger point -- without injecting any medication. The presence of the needle seems to break up the bunched fibers for some patients.
- Ultrasound Therapy: One method physical therapists may use to help myofascial pain syndrome is ultrasound therapy. Much like ultrasound imaging techniques, this therapy utilizes sound waves. Since myofascial pain is often helped by heat, the heat produced by the sound waves creates a warm massage sensation, helping the muscles to relax and improving blood flow.
