Myofascial Pain – Why Muscles Hurt!
April 27th, 2010
The following information is taken from The International Rehabilitation Medicine Association on Myofascial Pain Syndromes.
Why muscle hurt! The body has 500 muscles which makes up half of our body weight. Being the motors of the body they work with and against gravity together with the cartilage, ligaments and intervertebral discs they also serve as mechanical shock absorbers. Each one can be subjected to acute or chronic strain and develop myofascial trigger points and have own characteristic patterns of referred pain.
Definition of Trigger point (TP) A myofascial TP is defined as a “hyperirritable spot, usually within a taut band of muscle or in the muscle fascia, that is painful on compression and can give rise to characteristic patterns of referred pain and tenderness.
Incidence – A meaningful interpretation of incidence must distinguish between ACTIVE TPS that cause pain, either at rest or in relation to muscular activity and LATENT TPS. A latent TP may show all the diagnostic features of an active TP except that it causes pain only when the TP is palpated. The recognition and management of TPS is part of Physiotherapists training.
Recognition – Pain is dull, intense or aching and variable from hour to hour or day to day. Pain intensity strongly related to posture and muscular activity. Pain relates to the use of one muscle group and as such has specific referral pattern
Differential diagnosis – Referred pain of muscular origin can be confused with neurological pain or of a rheumatic/inflammatory origin which can be felt unrelated to muscular activity. Neurological pain is often associated with loss of or change in sensation and deficits that match a peripheral nerve or root distribution. Physiotherapist are trained to assess these differences.
Emotions like anxiety, anger, fear and frustration facilitates the development and perpetuation of myofascial TPS and intensifies the suffering caused by pain; psychological stress in turn is augmented by the uncertainties and limitations imposed by persistent pain, the cause of which is obscure and which can responds poorly and not quickly enough for our overwhelmed, stressed lifestyle.
Stretch and Massage the Scalenes!
The number of neck muscles, including the upper trapezius, sternomastoid, splenii and suboccipitals muscles, refer pain strongly to the head.
These muscles are frequently responsible for Tension headaches. Masticatory muscles are likely cause of head aches felt side of the head (often first thing in the morning), facial and jaw area, also earaches and toothaches.
Ever had pain referring to the front, sides and back of the shoulder regions as well as down to the index finger? The TPS in the 3 scalenes muscles can be responsible which are on either side of your neck. They also allow blood to flow into your arm and can lead to a number of problems. Ex: Thoracic Outlet Syndrome. Ever wonder why you sometimes get pain/ weakness/ numbness or tingling fingers at night in ring and pinkie fingers or wedding ring doesn’t fit in the morning? I had a patient once who thought he was having a heart attack because of Scalene TPS!
Upper Neck Exercise