Myofascial pain syndrome | Nuffield Health

What are the symptoms of myofascial pain?

Symptoms vary from person to person. The pain might flare up suddenly or sit in the background as a dull ache that doesn't fully go away.

Aching, throbbing, tight or vice-like muscle pain
A tender knot or bump you can feel in the muscle
Pain that spreads to a different part of your body when a trigger point is pressed
Sore or weak muscles
A smaller range of movement, such as not being able to fully turn your shoulder
Trouble sleeping and feeling unusually tired
Low mood or difficulty coping while the pain continues.

What causes myofascial pain, and who is at risk?

Doctors don't fully understand why myofascial pain develops in some people and not others, but muscle overload, whether from a single injury or from repeated strain, is thought to be a key factor.

A muscle injury or a single strain
Repetitive movements, such as typing or manual work
Poor posture
A muscle that's been inactive for a while, such as a limb in a cast or sling
Being in a cold environment
Emotional stress, which can make muscles tense
A pinched nerve
Thyroid disease, diabetes-related nerve damage, or other hormonal and metabolic conditions
A lack of vitamin D or folate
Ongoing infections
Smoking or being significantly overweight.

Myofascial pain is common. Some estimates suggest up to 85% of people will experience it at some point in their life.

Are there different types of myofascial pain?

Rather than different types of the condition itself, doctors classify the trigger points that cause myofascial pain into four categories.

Active trigger point: sits within a muscle and causes pain at that spot or along the same muscle when pressed.
Latent trigger point: currently dormant, but able to become active later.
Secondary trigger point: a separate, tender spot that forms in another muscle and can become irritated alongside the active one.
Satellite trigger point: becomes irritated simply because it's close to another trigger point.

How do doctors diagnose myofascial pain?

There's no scan or blood test that diagnoses myofascial pain directly. Instead, your doctor will physically examine your muscles, feeling for tight bands of muscle and pressing on them to find the exact spot that reproduces your pain, including anywhere it spreads to.

Your doctor will want to understand your pain in detail. Expect questions about which movements trigger or ease it, how it feels, how often it flares up, any recent injuries, and what your work or hobbies involve. They may also check your posture and the way you walk, and ask about your sleep and stress levels, since these can all play a part.

Blood tests or scans aren't used to confirm myofascial pain itself. Your doctor might still suggest them to check for other conditions with similar symptoms, or use a nerve and muscle test called electromyography (EMG) if there's a reason to look at other neuromuscular problems.

How is myofascial pain treated?

Treatment usually combines more than one approach, and it tends to work best when it starts early, before trigger points become established.

Physiotherapy, to stretch, strengthen and relax the affected muscles
Dry needling, where thin needles are placed directly in the trigger point to loosen it and reduce pain
Trigger point injections, which deliver a local anaesthetic and sometimes a steroid straight into the trigger point
"Stretch and spray", cooling the muscle with a coolant spray while it's gently stretched
Massage, ultrasound therapy, or low-level light (cold laser) therapy
TENS, or transcutaneous electrical nerve stimulation, which sends small electrical signals to the trigger point through pads placed on your skin
Pain-relief medicines, which may include NSAIDs, paracetamol, muscle relaxants, anticonvulsants or antidepressants, depending on your symptoms
Acupuncture and therapies such as biofeedback or cognitive behavioural therapy (CBT), particularly if sleep, stress or anxiety are also affecting you
Self-care measures such as heat or ice, gentle stretching and aerobic exercise, relaxation techniques, and improving sleep habits.

When is it time to get help for myofascial pain?

Muscle pain in a particular spot isn't improving despite rest, massage or other self-care
You notice a tender knot or trigger point that keeps causing pain
Pain is affecting your sleep, mood or daily activities
Symptoms have lasted 6 months or longer, since this is classed as chronic and tends to be harder to treat the longer it continues.

FAQs

What's the difference between myofascial pain syndrome and fibromyalgia?

Myofascial pain is usually confined to one region, or sometimes a few regions on the same half of the body. Fibromyalgia is different: it causes pain across the whole body, along with more widespread tender points, more severe fatigue, sleep problems and sometimes irritable bowel syndrome. The two can feel similar, but they're treated differently.
Is a trigger point the same thing as myofascial pain?

Not quite. A trigger point is the tender knot in the muscle that causes the pain. Myofascial pain, or myofascial pain syndrome, is the diagnosis you're given once that trigger point pain settles in and starts happening often.
How many people get myofascial pain?

It's very common. Estimates put lifetime risk as high as 85%, and for most people it shows up in just one part of the body rather than several.
Can myofascial pain be cured?

No single treatment suits everybody, but most people see real improvement once the underlying trigger points are addressed. Treating the cause, whether that's posture, stress or a vitamin deficiency, often helps the trigger points settle and the pain ease. Pain that has lasted 6 months or longer is classed as chronic and can take longer to treat.
Can stress cause myofascial pain?

Yes. Emotional stress can make your muscles tense, which is a recognised trigger for myofascial pain, alongside physical causes such as injury, repetitive movement and poor posture.