Myofascial Pain Syndrome

Myofascial pain syndrome denotes the sensation of muscular pain isolated to a particular area of the body.

Myo is the prefix referring to muscle and fascia is the tough connective layer of tissue that covers our muscles. In its normal state, the weave like tissue of the fascia, is supple and loose. Tension in the fascia, as a result of injury or trauma, can cause the tissue to become restricted, harder and less pliable – this exerts pressure on muscles and nerves, often causing hard knots to form. These are referred to as trigger points – a specific painful muscle spot that becomes tender when pressure is applied. Trigger points are associated with a number of musculoskeletal conditions; localised pain is felt at the trigger point itself, which more often than not causes referred pain (pain that is found in another area of the body, away from the source).

Note: Myofascial pain syndrome differentiates from fibromyalgia – the latter is a condition causing widespread chronic pain.


It is important to note that symptoms may be a result of a primary disorder – or, as a result of another process – a secondary pain syndrome, denoting deeper skeletal and joint problems such as arthritis or disc related complications.

Trigger points can be found during palpation of the muscles accompanied by stiffness, lack of movement and chronic pain which may be both localised and referred.

Other symptoms may include

  • Back pain
  • Neck pain
  • Headaches
  • Depression/mood alterations
  • Fatigue


Classically, palpation of muscle over the affected area, is associated with finding small knots in the muscle (trigger points). It is however, always important to suspect deeper pathology in the bony skeleton and to always examine thoroughly. If such abnormalities are found then an MRI and SPECT CT scan may be required.


myofascial painInjury – repetitive injury caused by sport, the workplace or other repetitive activities such as gardening

Lifting heavy objects, straining muscles

Continuous poor posture

Prolonged periods of inactivity – sitting/bed rest

Generally poor, unhealthy lifestyle



Hormonal changes

Pre-existing medical condition


Pain relief medications

Painkillers, anti-inflammatories and other medications such as anti depressants, may all be useful in the management of the symptoms of myofascial pain syndrome.

Physiotherapy and massage

A tailored physiotherapy program with specific exercises can gently stretch the muscles in the painful area without causing further discomfort; this over time, can restore a full range of painless movements – combined with strengthening exercises, can help rehabilitate muscles to their former strength. Massage and manipulation of the affected area may also be beneficial.

Trigger point injections

Can help reduce the pain and stiffness, improving mobility around the affected area. Trigger point injections are usually composed of a local anaesthetic and steroids.


Evidence has demonstrated that acupuncture or dry needling as it is often referred to, into the trigger point itself, can be very effective in managing the symptoms of myofascial pain syndrome.

Note: if simple acupuncture and physiotherapy do not help and deeper skeletal problems are diagnosed then treatment should be concentrated here.

How Dr. Miller Can Help

There is no need to suffer with debilitating pain; help is at hand! If you are suffering with pain and it will not go away despite the passage of time and using simple pain relieving medications, physiotherapy etc., then Dr. Miller can see you for a comprehensive evaluation of your problem.

Dr. Miller works closely with a range of colleagues: surgeons, physiotherapists and psychologists which are important in such care – the multidisciplinary team.

Email or call us on 020 7060 5109 for an appointment. Leave a message if you get through to a voicemail and you will be called back.


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