Muscles

Myofascial trigger points

Musculoskeletal pain can manifest as local or widespread pain. Myofascial pain syndrome is an example of a muscle pain condition characterised by local tenderness and referred pain caused by active myofascial trigger points.

Trigger points are not described by a specific anatomical location but are sites located in tight bands of muscle fibre. They can be hard and very sensitive or painful.

Myofascial trigger points are likely to be involved in various pain conditions such as back, neck and shoulder pain, tension-type headache and orofacial pain. The affected muscles display pain during movement, weakness, increased fatigue, stiffness, and slightly restricted range of motion that is unrelated to joint restriction.

Most trigger points occur because of muscle overuse, muscle trauma (injury), or psychological stress. Trigger points often arise from sustained repetitive activities, like lifting heavy objects at work or working on a computer all day. No single factor is responsible for the development of myofascial trigger points. A combination of contributing factors may include: poor posture, sitting for a long time in awkward positions, nutritional deficiencies, serious lack of exercise or movement, any injury to the joint system, generalised fatigue, lack of sleep, hormonal changes, emotional problems (depression, anxiety), other pain or inflammation conditions, weight gain, smoking and/or excess alcohol.

Chronic widespread pain

Widespread musculoskeletal pain is typically defined as both pain above and below the waist, and is also related to the spine and chest. Chronic, widespread pain includes syndromes such as fibromyalgia, whiplash-associated disorders, or pain triggered by trauma. Ongoing muscle soreness can lead to excessive pain signalling within the nervous system. This can make nerves sensitive and lead to chronic pain conditions.

Treatment of myofascial pain syndromes is sometimes multifactorial as pain can be driven by the nerve, joint or gut systems. Specific treatment of myofascial pain is known to decrease muscle tissue tension, promote relaxation, increase blood flow, reduce the fight/flight response, and decrease neuromuscular sensitivity.