Saturday, February 15, 2020

The Ins And Outs Of Chronic Myofascial Pain

Understanding chronic myofascial pain relies on our understanding of the illusive myofascial trigger point (TrP).


Trigger points (TrPs) are those knotted up pieces of muscle fiber that feel like a frozen pea in a taut band of average sized muscle. Anyone can usually feel a TrP unless it/they: 
  • are behind bone,
  • are in muscles that are under other muscle,
  • the muscle is too tight to locate the TrP.

If the band of muscle affected is too tight, it may be difficult to isolate the TrP causing pain. A specially trained physician or therapist may only be able to identify the TrP/s by the dysfunction and radiation of symptoms they create. A specific pattern is associated with the location of each specific TrP.


Myofascial trigger points are the root cause of chronic myofascial pain, also called myofascial pain syndrome or MPS. The cranky knots can cause symptoms that mimic many things. They are not only responsible for pain, they can also cause muscle and joint dysfunction, and they do not have to be big to be mighty. They can cause numbness and tingling, burning and other nerve symptoms when a TrP is entrapping a nerve. These symptoms can be local or radiate in a specific pattern that remains consistent among all patients. Circulation and temperature changes can occur if TrPs are located next to a blood vessel and swelling can develop if the TrP is located next to a blood or lymph vessel.

Trigger points can develop in anybody who experiences muscle strain or injury. Generally, these isolated events can be successfully treated with lasting results. However, that is not the case in myofascial pain syndrome. In MPS trigger points resist treatment, develop in other parts of the body, and persist for a prolonged period.  

You can read more about trigger points, how they are classified and additional resources in “What Is a Trigger Point?”, which is also provided in the header tab of this blog.


“Chronic myofascial pain is a disease that affects the chemicals that cross between nerve endings and muscles. It is literally, a disease at the neuromuscular junction—nerve to muscle... [it] is a chronic disorder in which myofascial trigger points (TrPs) cause sensory, motor, and autonomic symptoms. This condition may develop in muscles that are overstressed, overused, or injured. Different from isolated incidental occurrences of trigger points that can happen to normal individuals, CMP develops when TrPs are apparent in several quadrants of the body and have become chronic. The trigger points may be active, latent, or secondary.”

Excerpt from Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection by Celeste Cooper, RN and Jeffrey Miller PhD

Mayo Clinic (accessed February, 2020)  suggests sleep problems and development of fibromyalgia are complications of untreated myofascial pain syndrome. 

Myofascial pain syndrome coexists with many painful conditions. These include ─ but are not limited to ─ fibromyalgia and chronic fatigue/myalgic encephalomyelitis, migraine, spinal degeneration, teeth grinding, restless leg syndrome, TMJ, interstitial cystitis, irritable bladder, arthritic joints, congenital musculoskeletal malformation, repetitive motion, a static position, and more. Chronic myofascial pain can develop from the effect of diseases, such as polio, and can result from injury or post surgical scaring, too.

Hands on myotherapies, ultrasound guided trigger point injections, self-treatment of TrPs, controlling perpetuating factors are things we can do. It is helpful to know I have some control over the beast that can create so much agony.

Additional Reading:

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

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