Myofascial pain syndrome (MPS):

Wednesday, 04 May 2005 11:18


This condition causes muscular pain which can be relatively widespread.

Pain is caused by nodules (knots) causing areas of irritation in the muscle or fascia associated with the muscle (myofascia is a thin, virtually translucent film wrapped around muscle); these are known as trigger points (TrP), which are areas of irritation within extremely tight bands of muscle and or fascia..

TrPs can occur anywhere in the body and can result from over-use of muscles and/or muscle spasm (note: they are not the same as the tender points in Fibromyalgia).

The symptoms can often arise when the muscle is chilled. The pain may not remain localised, but can radiate to surrounding areas.

Latent TrPs do not hurt unless pressed, whereas 'active' TrPs trigger a referred pain pattern in the body, and often other symptoms in the 'pain zone'. Tension TrPs may occur if the muscles are continually held taut, which can often occur in unrelieved pain.

TrPs render muscle strength unreliable. This can cause difficulties such as with handwriting.

There is a red zone in which TrPs are particularly likely to occur. This covers a rectangular area from the neck to the buttocks.

Structural instability of the lower spine and pelvis can be a cause of MPS in the buttocks/hips.

Once established, this sort of problem can lead to symptoms even from stimulus such as lying on the affected side for a sustained period of time (say overnight).

The gluteus medius, one of the buttock muscles, can become shortened and this can make it more prone to develop TrPs.

The affected area may also go numb.

Another common area affected can be in the upper back over the shoulder blade (scapula) area that is caused by trigger points in the trapezius muscle, which runs up the side of the neck.

TrPs in the sternocleiodomastoid (SCM) muscle complex in the neck can cause dizziness, ringing in the ears and loss of balance. A common symptom of SCM TrPs is a 'drunken walk', and bumping into doorways and walls. Headaches are also often related to TrPs.

TrPs may refer burning, prickling or lightening-like pain; this can occur with nerve entrapment by affected muscles; of course, it may mimic or exacerbate nerve pain arising at a spinal level. The result is a highly confusing mixture of problems.

TrPs are also found in joint capsules and ligaments, and in periosteum ( the tissue around bones): the latter can cause autonomic reactions such as sweating.

Secondary trigger points develop when a muscle is subjected to stress because another muscle which has a TrP is not working properly.

Satellite TrPs occur when a muscle is in the pain zone of another TrP.

These 2 types may lead to widespread and severe pain and can give the false impression that MPS worsens over time.

In fact, MPS is a purely mechanical condition which is not progressive and with proper intervention, TrPs can be broken up and eliminated. However, this requires expert treatment from practitioners such as Chiropractors.

Autonomic manifestations of myofascial pain:

Matchstick test: firm indentations made with the blank end of a matchstick in the affected area will take longer to disappear than in unaffected areas.  (source: Myofascial Information Network, Washington, USA)

Perpetuating factors for MPS include:


This is a 'double whammy': MPS is a pain condition and FMS is a pain amplification condition: it is synergistic: the whole is greater than the sum of its parts.