Myofascial syndrome, what is it? You’re probably thinking I don’t have that, but more than likely, you have. Myo means muscle, and fascia refers to the tissue bands that cover and connect the muscles/organs.

• Tightness
• Twitching areas
• Painful knots

In the neck/back, then myofascial pain syndrome could be the cause. Myofascial syndrome is a very common condition. It affects about 44 million people in the United States.

Trigger Points The Areas Where Pain Can Develop

Myofascial pain is associated with trigger points. These are areas that can become tender and stiff inside muscle tissue that, reduce the range of motion. Myofascial pain syndrome can happen when you have several active trigger points. Trigger points are often referred to as knots because they feel tight and balled up compared to the softer relaxed surrounding muscle/s. If the muscle becomes tight, it can cut off its blood supply, which can trigger:

• Muscle tenderness
• Pain
• Spasm
• Tightness

Trigger points can form all over the body, which include:

• Neck
• Mid-back
• Low back

Common characteristics of trigger points are that they cause pain that travels or spreads to the surrounding area. For example, shoulder pain can radiate across the upper back. The muscles can also twitch when touched.

Pretty much everyone has trigger points, but not all triggers cause symptoms.

• Dormant or latent  trigger points can reduce the range of motion but only cause pain when directly palpated or compressed,
• Active trigger points are painful at any time, even when at rest.

Lifestyle factors like:

• Stress
• Poor posture

Can make a dormant trigger point become active?

Trigger Point Causes in the Spine

Spinal injury or trauma can result in myofascial pain syndrome, but lifestyle factors usually have a hand in the condition. Poor posture over a long period, for example, sleeping in an awkward position, can cause physical muscular stress on the spinal muscles. Mental and emotional stress can present itself through muscle tension that helps the development of trigger points. The trapezius muscle that extends from the back of the neck down the shoulders and upper back is the most common site of spinal trigger points and myofascial pain because of the significant amount of pressure the muscle has to bear susceptibility to whiplash.

The Difference between Myofascial Syndrome and Fibromyalgia

Because the myofascial syndrome is linked to triggering points, fibromyalgia and its tender points bring out a comparison of the two. Myofascial pain syndrome and fibromyalgia are two distinct conditions, and the table below outlines the primary differences.

Because they are unique conditions, developing both conditions is possible. Doctor(s) can help craft a treatment approach that addresses the pain of both trigger points and tender points.

Diagnosis can be difficult

Myofascial pain syndrome is common but can be difficult to diagnose.

The challenging reasons behind diagnosing include:

• Scientists are not sure how these trigger points cause pain.
• The condition is often confused with other spinal disorders and conditions.

An example is having low back pain caused by myofascial syndrome in the lumbar spine. But low back pain brought on by arthritis can cause similar pain. That’s when the cause needs to be carefully and properly assessed.

• There is no standard test for myofascial pain syndrome diagnosis yet.

There’s no standard diagnosing protocol but manual palpation or use of the hands to feel for:

• Tenderness
• Twitching
• Tightness around the area

Is the most common way doctors diagnose the condition. Some doctors might only utilize manual palpation, but ultrasound is emerging as a diagnostic tool for myofascial pain syndrome. Ultrasound produces clean images of the soft tissues and shows the active trigger points. However, more research is needed to secure its place as a diagnostic method and tool. A personal or primary care doctor can diagnose myofascial syndrome, but they may refer you to a pain specialist or a spine specialist like:

• Chiropractor
• Physiatrist
• Physical therapist
• Massage therapist

For extended evaluation and treatment.

Treatment

Doctors and researchers are still learning about myofascial syndrome; therefore, treatment options differ from doctor to doctor. But most doctors support a multidisciplinary treatment approach, that is, using a variety of therapies and employing lifestyle changes to manage trigger point pain and prevent it from returning. Below are common treatments for myofascial pain syndrome.

Release Therapy

Myofascial release is a broad treatment option consisting of manual or instrument-guided therapy designed to release the muscles and fascia by applying pressure. There are different release therapies, such as:

• Graston Technique
• Melt Method
• Active Release Technique

Practitioners and clinicians are trained in myofascial release therapy, including:

• Massage therapists
• Physical therapists
• Chiropractors
• Physiatrists

The goal is the same:

Put pressure on the trigger point and release it. Myofascial release technique might sound like a massage, but it is a distinct method compared to massage. Massage moves muscles up and down; myofascial release utilizes direct pressure into the stiff fascia and muscle. Repeated pressure on the tight areas is not soothing, and patients tell of soreness during and after the treatment. Once the trigger point loosens up, blood flow and nerve function begin to return to the area.

Additional Care Options

Myofascial release therapy is just one option for trigger point pain. Other common treatments to manage spine-related pain include:

Home

If you know the location of the trigger points, you can treat them at home with simple tools. Rolling the trigger point over a:

• Foam roller
• Golf ball
• Tennis ball

Can help loosen any of the tight areas?

Over-the-counter medication

If doctor-approved, then taking an over-the-counter pain reliever like acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) can help with spine pain and allow daily activities.

Physical therapy

Physical therapy like:

• Massage
• Chiropractic
• Heat
• Electrical stimulation
• Ultrasound

There are also stretches/exercises to keep muscles warm and flexible to help any future trigger points from forming.

Massage therapy

Licensed massage therapists practice myofascial release therapy but also include other forms of massage

• Deep tissue massage
• Swedish massage

Can also help relieve trigger point pain.

Massage can also help to relax, and this is very important in preventing myofascial pain syndrome. Also, learn how to keep stress and anxiety in check and avoid tension that can turn into trigger points.

Dry needling/acupuncture

While both therapies use needles, dry needling and acupuncture are different treatments that can reduce pain. There is not a lot of research on dry needlings, like acupuncture, but it can help increase blood flow to the trigger point area. Acupuncture means inserting needles into specific points on the body. These needles help stimulate the body’s energy and help in sending signals to the nervous system to release chemicals into the body to help with the pain, which means less pain.

Trigger point injections

If any of these treatments aren’t working, you might want to talk to your doctor about trigger point injections. Trigger point injections can help relieve pain, and a doctor usually recommends them to be done along with a physical therapy/chiropractic treatment program.

Keep the Pain Away & Prevention

Many people with trigger points or myofascial pain syndrome in their spine have knots and tightness throughout their back and neck. To prevent myofascial pain syndrome, one must practice a healthy lifestyle promoting good spine health. Stretching and exercising regularly can help keep stress under control and prevent tension from building up, which makes it harder for trigger points to activate and cause pain.

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Chiropractor Low Back Pain Therapy

 

Andres “Andy” Martinez first came to see Dr. Alex Jimenez in Push Fitness after experiencing back pain and knee problems. Following a period of physical therapy and rehabilitation, Andy became involved in PUSHasRx Functional Fitness Workouts, where he learned everything he needed to know about health and wellness from the trainers at Push. Andres Martinez expresses how grateful he is to receive the amount of care he does from the staff, and he describes how much his perspective of fitness has changed from the first time he walked in to Push Fitness. Andy has found a family at Push who led him to a healthy, clean life; the trainers and staff mean everything to Andres.

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NCBI Resources

The knots you have probably felt in your muscles or had others identify are also known as trigger points. These tight spots are often sensitive to the touch and can be found in any muscle in your body. They may produce symptoms like numbness, burning, weakness, pain, and tingling as they develop. Trigger points are caused by trauma to the body, such as an accident in a car or during athletics. They can also be caused by mild, long-term trauma, such as working at a desk without proper ergonomics or repetitive motions over a long period. Chiropractors are not only good at finding trigger points, but they are also good at treating them.