Myofascial pain syndrome — causes, symptoms and treatment
Myofascial pain syndrome of different localization
Myofascial pain syndrome is a specific painful condition that is manifested by emergence of painful spasm of the muscles and muscular dysfunction.
The disease precedes the appearance of muscle fibers painful seals, called trigger points. They are usually localized to areas of spasm, tight muscle bundles or in the fascia.
Perhaps no man, never experienced in my life pain in the muscles. Therefore, our relaxed attitude to these painful manifestations are well founded.
Most people suggest that it possesses a natural character. But, unfortunately, in the majority of cases pain in the skeletal muscles are the symptoms of myofascial syndrome.
Myofascial pain is a reflex pain due to the appearance of impulses from receptors in response to changes in the ligaments, discs and joints of the spine.
Usually, the problem area is the back area, as is often the patient presents to the doctor’s complaints of pain in the back. Often this pain is caused by problems associated with the muscular apparatus.
For myofascial pain is characterized by the formation of sections of the seal in the fibers of the muscle or fascia called trigger zones. They often occur on the background of osteochondrosis of the spine is influenced by muscle tension.
Muscles almost all the time respond to pain impulses tonic reflex response.
Physiologically the muscle tension that follows any pain, substantiated by immobilization of the affected area of the body, create its muscular corset. But the muscle is a source of additional pain.
Also muscles may be affected initially without any morphological or functional disorders of the spine. Any surplus types of muscle tension can lead to dysfunction of the tissue with the formation of pain syndrome.
Causes of the syndrome
Myofascial syndrome is a lot of people who are exposed to constant sports or heavy physical labor.
Periodic minor injuries cause damage to the individual bundles of muscles, as a result it creates inflammation, which ends with the formation of sections of scar tissue.
The localization of the scar close to nerve fibers may occur a very distinct and intense pain.
The most common reason that occurs vertebrogenic myofascial syndrome is low back pain.
Osteochondrosis irritated nerve Lutsak, innervating structures of the spine. That is what leads to reflex spasm of paravertebral muscles and the remote. Due to a prolonged stay in a state of spasm in the muscle after some time formed an active trigger point.
Developmental abnormalities of the human body are also a cause of myofascial pain.
The main factor in this case is body asymmetry and leg length difference. Different length of feet is very common, but the value it has if it is more than one centimeter.
Uneven load distribution on the foot, shank, thigh and lumbar, their constant strain leads to spasm and develop trigger points.
Pain syndrome developing on a background of anatomical disorders, it is associated with certain habits. For example, myofascial pain syndrome of the face, is associated with the habit of squeezing the jaws under stress.
The risk factors that contribute to the development of pain syndrome include:
- wearing the oppressive clothing or accessories, such as corsets too tightly tightened belts, heavy bags on one shoulder;
- sports and heavy physical labor;
- significant weight (obesity);
- the immobilized limb;
- diseases of the spine;
- emotional instability.
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To the syndrome may manifest in different muscle groups. Therefore, there are the following myofascial pain localization:
- lumbar pain;
- pain in shoulder and neck;
- chest pain;
- pain in the abdomen;
- pain in the pelvic region;
- femoral pain;
- pain in the jaw;
- pain of the lower extremities;
- pain of the upper limbs.
This files most often diagnosed myofascial syndrome of the cervical spine, the most rare region of the pelvic floor.
Syndrome usually have clear symptoms that are associated with the occurrence of spasm of the muscles, presence of trigger points, decreased range of motion of the affected muscle.
There are two types of trigger points:
- Active trigger points are characterized by pain, manifested in the localization of points, and in remote areas. The pain occurs at rest and during movement. Each point is a specific place of reflection pain. The site of the lesion may experience changes in sweating, skin color, may cause hypertrichosis. The stimulation of trigger points occurs local convulsive response, the so-called «symptom-hop», which is manifested by the contraction of the muscle and severe pain.
- Latent trigger points are more common active. When palpation occurs local pain, the pain in remote areas does not occur. Activated latent trigger points are aggravating factors such as hypothermia, postnichestve stress, emotional stress, excessive physical activity, anxiety and others. During a short rest, warmth and adequate therapy of possible transfer of active trigger points in a latent state.
There are three phases of current myofascial pain dysfunction:
- The first phase is acute. It is characterized by constant excruciating pain in a particularly active trigger points.
- The second phase is characterized by pain that occurs only during movement, and absent at rest.
- The third phase is chronic. It is characterized by the presence of dysfunction and discomfort in the relevant field.
When muscle pain, it is primarily necessary to exclude an inflammatory etiology, and vertebral compression radicular and spinal pathology.
To identify trigger points need to master the correct technique of palpation.
You need to stretch the muscles along the length, at the peak of stimulation of pain among the relaxed muscle will be palpable cord in the form of a taut cord, and along it is the point of greatest pain, when pressing on that occurs referred pain.
Use two methods of palpation: deep and tick-borne.
In the implementation of deep palpation, the doctor should be with the fingertips across the muscle fiber.
In the implementation of the tick-borne palpation the doctor grabs the belly of the muscle the thumb and other fingers, then he seemed to «roll» the muscle fiber between them, revealing at the same trigger points.
At diagnosis are guided by the following criteria:
- The Association of pain with physical overloads, podoconiosis stress or hypothermia.
- The definition in the muscles tight and painful cords. The absence of Hypo — or muscle atrophy.
- The spread of pain to areas remote from tense muscle areas
- The presence of portions of more muscle seals within tight muscles. With pressure on them the pain increases sharply – «symptom of the leap.»
- Reproduction of referred pain in the compression or puncture trigger points.
- Westernmost symptoms at a particular local effect on tense muscles.
When the diagnosis of myofascial pain syndrome treatment is possible.
The causes of pain
The first is aimed at elimination of the reason causing the pain.
It also is the prevention of the onset of pain. Posture should be corrected with the help of special pathogenetic complex exercises. With different leg length using special insoles thickened at 0.3-0.5 inches. And so with every violation.
Treatment of pain
The second is directed to the treatment of pain.
There are two areas of medication therapy: impact on the vicious circle of the pathogenesis and effects on the Central nervous system.
To break the vicious circle of the pathogenesis of the disease prescribe muscle relaxants, as they provide a reduction of pain impulses from the periphery. Doctors usually prescribe drugs such as Baclofen, Mydocalm, sirdalud.
To prevent pain in the chronic form with the formation of the syndrome of vegetative dystonia are appointed by the GABA alicesme drugs such as noofen, adaptol; sedatives, antidepressants, wegetotropona preparations.
Non-pharmacological treatment is the use of techniques such as post isometric relaxation of the affected muscle, needling trigger points, acupressure, massage and physiotherapy.
Post isometric relaxation of the affected muscle is the most effective method of treatment. Its essence lies in the tension of the affected muscle and the subsequent work in isometric mode within ten seconds.
Then the technique is repeated three to five times depending on the severity of the muscle tension.
Rehabilitation and recovery
The third area is rehabilitation. The main objective of rehabilitation is the creation of correct movement patterns, teaching the patient the ability to control their own bodies, the establishment and strengthening of a muscular corset.
Special attention is paid to the complex corrective and restorative exercises, correcting at correct performance posture.
Launched myofascial pain syndrome can lead to the development of fibromyalgia.
Fibromyalgia is a chronic disease characterized by symmetrical pain almost all over body.
People suffering from this disease, can’t sleep, they have problems with digestion, there is chronic fatigue.
Therefore, you should pay attention to the presence of myofascial pain and start treatment in time.