What is Myofascial Pain and how do you treat it?

You have likely heard the term “myofascial pain” or “myofascial pain syndrome” being thrown around.

Most people are familiar with the prefix “Myo” as it refers to muscles. “Fascia” is a thin sheet or band of connective tissue made primarily of collagen that helps to attach and separate muscles and internal organs. It surrounds and attaches to all structures within the body.

Situations can develop where the muscles or fascia become chronically irritated and painful, sometimes including painful knots or trigger points.

The true cause of myofascial pain is not fully understood. It could be a response to an injury, or repetitive microtrauma such as posture or work related stresses. Some systemic conditions can also contribute to myofascial pain.

Diagnosis and treatment of myofascial pain

A medical provider should be the one to accurately diagnose your condition. It is important not to miss an underlying pathology that may be the root cause of the pain, such as a spinal condition or systemic disease. Once these pathologies have been ruled out, there are many techniques that can be helpful to relieve myofascial pain.

Foam rolling, trigger point release techniques with various tools, massage, and dry needling may all be helpful. The risks of these types of treatment techniques are low, although soreness can be common when starting any program. From a research standpoint, long term benefit from these interventions is not clear.

As a general rule, active exercise is more beneficial in the long term than more passive treatment approaches. This can be a challenge for some people where even basic movements are painful. Getting on a program of regular, low intensity exercise is the key. Gentle sustained stretching, postural education, or Tai chi can be good ways to get started.

People with more severe levels of pain may benefit from exercise in a more supportive environment such as an aquatic therapy pool. With time, the goal is to advance into more high level exercise and strength training.

Chris Gabriel PT, OCS, CSCS is a physical therapist with the OrthoCarolina Sports Training Center.