Myofascial pain syndrome is manifested by severe pain in the muscles surrounding the spine. The painful sensations are due to muscle spasms caused by an imbalance in the transverse striated myocytes, such as in trauma, osteochondrosis, hypothermia, and others. This process results in trigger points – extremely irritated areas of skeletal muscles. Such seals are small in size – about 1-3 mm, but the spasm is able to expand, forming large areas of hypersensitivity.
Symptoms of myofascial pain syndrome
There are 3 main stages of myofascial pain syndrome development with inherent characteristic symptoms:
- Stage 1 is characterized by a latent chronic course of the pathology. The patient has a feeling of discomfort, asymmetry of body position is felt, pain occurs when pressing on trigger points.
- Stage 2 – pain is manifested with physical activity and body movement. At rest, there is no pain.
- Stage 3, the most severe. Pain is present both with physical activity and at rest.
The most common problem encountered by patients with myofascial pain syndrome is limitation of the amplitude of body movement due to intense painful sensations of muscle contraction. On examination, the asymmetry of muscles and the presence of compacted painful areas are clearly visible. Often there are reflected pains – painful sensations located in places distant from the real source of the lesion.
Causes of myofascial pain syndrome
Myofascial pain syndrome occurs in response to a combination of predisposing and provoking factors.
First of all, the pathology is caused by a violation of body movements, in which there is an overstrain of various muscle fibers. Thus, myofascial pain syndrome can lead to posture and gait disorders: scoliosis, kyphosis, lordosis, short leg syndrome, flat feet, etc. Also, pathology often accompanies osteochondrosis, intervertebral hernias and other spinal diseases.
Myofascial pain syndrome can be provoked by prolonged presence in a forced posture (for example, due to work), as well as constant physical exertion (for example, when practicing professional sports).
The following provocative factors can trigger the development of pain syndrome:
- acute muscle overload – heavy lifting, sudden bending or twisting of the torso;
- trauma;
- obesity;
- metabolic disorders;
- hypothermia;
- avitaminosis;
- stress;
- hypodynamia;
- infectious lesions;
- intoxication of the body (especially smoking, alcohol and drug use).
Diagnosis
The diagnosis of “myofascial pain syndrome” is established by a neurologist or neurosurgeon on the basis of patient complaints, personal examination and hardware diagnostic methods.
At the initial appointment, the doctor interviews the patient about the symptoms, their duration, localization and intensity of pain. Also, the specialist identifies the presence of predisposing factors (spinal diseases in the anamnesis, sedentary work, excessive loads, etc.). After the conversation, the neurologist proceeds to the examination of the patient. Using the method of palpation, the specialist determines the location of active triggers, assesses posture, amplitude of movements of various parts of the body. Much attention is paid to assessing the nerves, checking reflexes, detecting numbness and tingling of the extremities.
Complications
Myofascial pain syndrome is not fatal, but it significantly worsens the quality of life and reduces the ability to work. Chronic pain adversely affects the psycho-emotional sphere of a person, he feels constant fatigue, sleeps poorly. Due to sleep disorders, the patient not only fails to cope with professional duties, but also cannot solve simple household tasks. He becomes nervous and apathetic. He may have difficulties with communication.
If myofascial pain syndrome is caused by osteochondrosis, scoliosis or other pathology, without proper treatment, the symptoms of these diseases will worsen, further complicating the situation.
Also spasmed muscles can squeeze vessels and nerves. This can result in sciatica and vasomotor disorders, such as pale skin or excessive sweating.
Conservative treatment
Conservative treatment for myofascial pain syndrome includes several avenues, each of which can help relieve symptoms and improve the condition. Here are the main treatments:
- Medical treatment
Medication treatment is aimed at relieving pain and relaxing tense muscles. For this purpose, painkillers, non-steroidal anti-inflammatory drugs, and in some cases antidepressants are used to improve psycho-emotional state and reduce sensitivity to pain.
- Chiropractic care
Chiropractic care involves using your hands to work on inflamed muscles and joints. The practitioner helps restore normal tone by working the muscles and stretching painful areas. It may also involve working on joints and bones to improve their mobility.
- Physiotherapy
Physiotherapy methods include procedures such as magnetotherapy, laser therapy, shockwave therapy and electrophoresis. These methods activate metabolic processes in the muscles, help reduce inflammation and alleviate pain.
- Acupuncture
Acupuncture helps improve circulation and relieve muscle tension. The practitioner inserts thin needles into painful areas, which helps to relax the muscles and reduce pain.
Surgical treatment
High-frequency denervation allows you to quickly get rid of myofascial pain syndrome for a long time. This is a minimally invasive operation aimed at “disconnecting” the nerves of the affected area, after which they stop transmitting information about painful sensations to the brain.
To do this, the doctor inserts needles with electrodes into the inflamed area. They transmit an electric current that destroys the nerve endings. All manipulations are performed under local anesthesia.
The positive effect of high-frequency denervation lasts about a year. During this time, the patient does not need additional treatment and does not need to take any medications.
Prevention of myofascial pain syndrome
The probability of developing myofascial pain syndrome depends largely on the level of physical activity, and both overexertion and a sedentary lifestyle are equally dangerous. The risk also increases with increasing age.
The best prevention is regular and moderate physical activity. Elastic and flexible muscle fibers with a good blood supply will either not be affected at all by overload, or will suffer minimal damage and recover quickly.
The World Health Organization recommends that all people 18 years of age and older:
- do not neglect exercise in the morning;
- walk or Nordic walking 2.5 to 5 hours a week;
- run 1.5 to 2.5 hours a week;
- spend as little time as possible sitting or lying down;
- do muscle strength exercises at least twice a week.
A healthy lifestyle, correct posture, absence of excess weight, observance of the daily regimen – all this also reduces the likelihood of the syndrome. It is also necessary to visit doctors in time to treat musculoskeletal diseases.
If you experience symptoms that may indicate myofascial pain syndrome, it is recommended to consult a doctor.
