At this point in time medical science doesn't know what causes Myofascial Pain syndrome (MPS), or how to cure it. There is no specific diagnostic laboratory test to confirm Myofascial pain. Unfortunately only a small percentage of physicians recognize the complex clinical conditions that accompany this syndrome. At present, after being correctly diagnosed, the medical community can only offer symptomatic treatment. There are many similarities between Myofacial Pain syndrome and Fibromyalgia. Myofascial patients have very painful "Trigger Points," bulges or taut bands in muscles that when pressured, refer pain to distant parts of the body. Many times Fibromyalgia patients have these taut bands and "Trigger Points" and are not aware of this fact. As with Chronic Fatigue Syndrome and Fibromyalgia, patients with MPS many times don't appear to sick, so they are once again victimized by physicians, family members, and friends. MPS can be totally debilitating to the patient.

MYOFASCIAL SYMPTOMS

Patients with MPS have symptoms that include...
1. Numbness
2. Dizziness
3. Headaches
4. Concentration and Memory problems
5. Sleep Disorders
6. Fluid Retention
7. Balance Problems
8. Muscle Pain
9. Stiffness
Myofascial patients end up with taut bands in muscles that contain "Trigger Points" that are notorious for referring pain. The taut bands causes the muscles to tighten and spasms, which entraps nerves, blood vesels and ducts. MPS, once started, has the ability to spread to other muscles.

WHAT CAUSES THE DISORDER?

Controversy is never far away when referring to the cause of MPS. Medical science simply doesn't know what causes the disorder or how to cure the disease. There are conflicting concepts as to what is actually happening in these patients. This adds to the overall validity problem of receiving a correct diagnosis. Theories of the cause of MPS have included chronic viral infections, psychiatric conditions, stress, muscle overload, neurotransmitters, neuromuscular problems, deep sleep abnormality, chronic fatigue, irritable bowl syndrome, and the central nervous system. Sleep disorders seem to be the most noticed symptom.

PRESCRIPTION DRUGS FOR SYMPTOMS

At this point in time the medical community is only able to treat symptoms rather than the underlying disease. These treatment modalities may help particular symptoms but will not cure the disorder. Prescription drugs that have been tried include Anti-Depressants, Tranquilizers, Muscle Relaxers, and Pain Relievers. As with all diseases, each patient will react different to specific medications. Examples of drug therapies have included...
Amitriptyline (Elavil)
Trazadone (Desyrel)
Diphenhydremine (Benadryl)
Cyclobenzaprine (Flexeril)
Alpramazolam (Xanax)
Carisprodol (Soma)
Hydrocodone (Vicodin)
Trigger Point Injections, a mixture of anesthetic and steroids, work as "Nerve Blocks." The anesthetic numbs the muscle and the steroid is used to reduce swelling of the taut bands in the muscles. Pain management is very important in coping with this chronic illness. Unfortunatley, many patients have not reported sustained relief from Trigger Point Injections. Some patients are desperate enough to opt for the short period of relief these injections may offer.

KNOWN TREATMENTS FOR MPS

1. STRETCH AND SPRAY. At present this only provides temporary relief for the symptoms of MPS. Stretching a muscle and spraying the muscle with ethyl chloride is the distraction to the central nervous system. This treatment will sometimes deactivate a trigger point on a temporary basis.
2. ACUPUNCTURE. This treatment will or will not work on a patient to patient basis.
3. ULTRA SOUND. potentially, this porcedure may destroy an active trigger point.
4. MEDICATIONS.
5. CYROTHERAPY. This procedure freezes a nerve for three to four months. The nerve will regenerate itself in a given time. This limits the number of procedures the MPS patient must endure.
6. PHYSICAL THERAPY. Can help to reduce pain. Patients must be careful not to over-due it, which could make pain, or other symptoms, worse. Caution should be taken because mnay physicians and physical therapists do not understand the damage they do by prescribing or practicing physical therapy for Myofascial patients.

++++Studies++++:

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Fortschr Med 1998 Sep 30;116(27):24-9 [Myofascial pain syndrome--frequent occurrence and often misdiagnosed]. [Article in German] Pongratz DE, Spath M Friedrich-Baur-Institut bei der Medizinischen Klinik, Klinikum Innenstadt, Universitat Munchen. Myofascial pain syndrome (MPS) is a very common localized--sometimes also polytopic--painful musculoskeletal condition associated with trigger points, for which, however, diagnostic criteria established in well-designed studies are still lacking. These two facts form the basis for differentiating between MPS and the fibromyalgia syndrome. The difference between trigger points (MPS) and tender points (fibromyalgia) is of central importance--not merely in a linguistic sense. A knowledge of the signs and symptoms typically associated with a trigger point often obviates the need for time-consuming and expensive technical diagnostic measures. The assumption that many cases of unspecific complaints affecting the musculoskeletal system may be ascribed to MPS makes clear the scope for the saving of costs. Publication Types: ?Review ?Review, tutorial PMID: 9816749, UI: 99033537

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Pain 1999 Jan;79(1):39-44 A blinded pilot study investigating the use of diagnostic ultrasound for detecting active myofascial trigger points. Lewis J, Tehan P Department of Physiotherapy, Hadassa University Hospital, Jerusalem, Israel. Myofascial trigger points (MFTPs) have been cited by numerous authors as the cause of local and referred pain which arises from muscle and its surrounding fascia. At present there is no reliable objective test which is capable of determining their presence. It was the purpose of this pilot study to assess the use of diagnostic ultrasound in determining any soft tissue changes in the region of clinically identified active MFTPs. Eleven subjects with clinically identified, unilateral, active MFTPs were examined with diagnostic ultrasound at the site of the trigger point as well as the asymptomatic, contralateral side. The analysis of the results of this pilot study found no correlation between the clinical identification of active MFTPs and diagnostic ultrasound. Publication Types: ?Clinical trial PMID: 9928774, UI: 99125854

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Myofascial Release

MYOFASCIAL PAIN SYNDROME