Skip to main content
SpringerLink
Log in

Myofascial Pain

  • Chapter
  • First Online:
Functional Illness of the Head and Neck

  • 461 Accesses

Abstract

Myofascial pain is commonly seen in clinical practice. However, the existence of myofascial pain is debated due to the paucity of convincing biological plausibility. A thorough history and physical examination is important to characterize the pain, identify associated features, and to rule out other conditions that may present similarly. Additionally, it is important to identify patient specific functional goals to guide management. Select investigations can be helpful in working up the patient with myofascial pain. Treatment has limited evidence and follows the approach of conservative, pharmacological, and interventional options.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fernández-de-las-Peñas C, Dommerholt J. International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: a Delphi study. Pain Med (United States). 2018;19(1):142–50.

    Article  Google Scholar 

  2. Han SC, Harrison P. Myofascial pain syndrome and trigger-point management. Reg Anesth. 1997;22(1):89–101.

    Article  CAS  PubMed  Google Scholar 

  3. Gerwin RD, Dommerholt J, Shah JP. An expansion of Simons’ integrated hypothesis of trigger point formation. Curr Pain Headache Rep. 2004;8:468–75.

    Article  PubMed  Google Scholar 

  4. Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L. Myofascial trigger points then and now: a historical and scientific perspective. PM and R. Elsevier Inc. 2015;7:746–61.

    Article  PubMed  Google Scholar 

  5. Keskindag B, Karaaziz M. The association between pain and sleep in fibromyalgia. Saudi Med J. Saudi Arabian Armed Forces Hospital. 2017;38:465–75.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: An update and a path forward. J Pain. NIH Public Access. 2013;14:1539–52.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Consoli G, Marazziti D, Ciapparelli A, Bazzichi L, Massimetti G, Giacomelli C, et al. The impact of mood, anxiety, and sleep disorders on fibromyalgia. Compr Psychiatry. 2012;53(7):962–7.

    Article  PubMed  Google Scholar 

  8. Arnold LM, Hudson JI, Keck PE, Auchenbach MB, Javaras KN, Hess EV. Comorbidity of fibromyalgia and psychiatric disorders. J Clin Psychiatry. 2006;67(8):1219–25.

    Article  PubMed  Google Scholar 

  9. Swain CTV, Pan F, Owen PJ, Schmidt H, Belavy DL. No consensus on causality of spine postures or physical exposure and low back pain: a systematic review of systematic reviews. J Biomech. Elsevier Ltd. 2020;102

    Google Scholar 

  10. Fitzcharles MA, Ste-Marie PA, Goldenberg DL, Pereira JX, Abbey S, Choinière M, et al. 2012 Canadian guidelines for the diagnosis and management of fibromyalgia syndrome: executive summary. Pain Res Manage. Hindawi Limited. 2013;18:119–26.

    Article  Google Scholar 

  11. Gerwin RD, Duranleau D. Ultrasound identification of the myofascial trigger point. Muscle Nerve. 1997;20(6):767–8.

    CAS  PubMed  Google Scholar 

  12. Chen Q, Bensamoun S, Basford JR, Thompson JM, An KN. Identification and quantification of myofascial taut bands with magnetic resonance elastography. Arch Phys Med Rehabil. 2007;88(12):1658–61.

    Article  PubMed  Google Scholar 

  13. Amer-Cuenca JJ, Pecos-Martín D, Martínez-Merinero P, Girbés EL, Nijs J, Meeus M, et al. How much is needed? Comparison of the effectiveness of different pain education dosages in patients with fibromyalgia. Pain Med (United States). 2020;21(4):782–93.

    Article  Google Scholar 

  14. Louw A, Zimney K, Puentedura EJ, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: a systematic review of the literature. Physiother Theory Pract. Taylor and Francis Ltd. 2016;32:332–55.

    Article  PubMed  Google Scholar 

  15. Watson JA, Ryan CG, Cooper L, Ellington D, Whittle R, Lavender M, et al. Pain neuroscience education for adults with chronic musculoskeletal pain: a mixed-methods systematic review and meta-analysis. J Pain. Churchill Livingstone Inc. 2019;20:1140.e1–1140.e22.

    Article  PubMed  Google Scholar 

  16. Nicassio PM, Radojevic V, Weisman MH, Schuman C, Kim J, Schoenfeld-Smith K, et al. A comparison of behavioral and educational interventions for fibromyalgia. J Rheumatol. 1997;24(10):2000–7.

    CAS  PubMed  Google Scholar 

  17. Michelotti A, Steenks MH, Farella M, Parisini F, Cimino R, Martina R. The additional value of a home physical therapy regimen versus patient education only for the treatment of myofascial pain of the jaw muscles: short-term results of a randomized clinical trial. J Orofac Pain. 2004;18(2):114–25.

    PubMed  Google Scholar 

  18. Lin SY, Neoh CA, Huang YT, Wang KY, Ng HF, Shi HY. Educational program for myofascial pain syndrome. J Altern Complement Med. 2010;16(6):633–40.

    Article  PubMed  Google Scholar 

  19. Hong CZ, Chen YC, Pon CH, Yu J. Immediate effects of various physical medicine modalities on pain threshold of an active myofascial trigger point. J Musculoskelet Pain. 1993;1(2):37–53.

    Article  Google Scholar 

  20. Hou CR, Tsai LC, Cheng KF, Chung KC, Hong CZ. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Arch Phys Med Rehabil. 2002;83(10):1406–14.

    Article  PubMed  Google Scholar 

  21. Vernon H, Schneider M. Chiropractic Management of Myofascial Trigger Points and Myofascial Pain Syndrome: a systematic review of the literature. J Manip Physiol Ther. 2009;32:14–24.

    Article  Google Scholar 

  22. Ceylan Y, Hizmetli S, Siliğ Y. The effects of infrared laser and medical treatments on pain and serotonin degradation products in patients with myofascial pain syndrome. A controlled trial. Rheumatol Int. 2004;24(5):260–3.

    Article  CAS  PubMed  Google Scholar 

  23. Thomas E, Cavallaro AR, Mani D, Bianco A, Palma A. The efficacy of muscle energy techniques in symptomatic and asymptomatic subjects: a systematic review. Chiropr Man Ther. BioMed Central Ltd. 2019;27

    Google Scholar 

  24. Lewit K, Simons DG. Myofascial pain: relief by post-isometric relaxation. Arch Phys Med Rehabil. 1984;65(8):452–6.

    CAS  PubMed  Google Scholar 

  25. Ahmed S, Khattab S, Haddad C, Babineau J, Furlan A, Kumbhare D. Effect of aerobic exercise in the treatment of myofascial pain: a systematic review. J Exerc Rehabil. Korean Society of Exercise Rehabilitation. 2018;14:902–10.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Cantarero-Villanueva I, Fernández-Lao C, Fernández-de-las-Peñas C, López-Barajas IB, Del-Moral-Ávila R, de la-Llave-Rincón AI, et al. Effectiveness of water physical therapy on pain, pressure pain sensitivity, and myofascial trigger points in breast cancer survivors: a randomized, controlled clinical trial. Pain Med (United States). 2012;13(11):1509–19.

    Article  Google Scholar 

  27. Mata Diz JB, de Souza JRLM, Leopoldino AAO, Oliveira VC. Exercise, especially combined stretching and strengthening exercise, reduces myofascial pain: a systematic review. J Physiother. 2017;63(1):17–22.

    Article  PubMed  Google Scholar 

  28. Kim W, Hur MH. Effect of resistance exercise program for middle-aged women with myofascial pain syndrome on shoulder pain, angle of shoulder range of motion, and body composition randomized controlled trial. RCT J Korean Acad Nurs. 2020;50(2):286–97.

    Article  PubMed  Google Scholar 

  29. Mansoori SS, Moustafa IM, Ahbouch A, Harrison DE. Optimal duration of stretching exercise in patients with chronic myofascial pain syndrome: a randomized controlled trial. J Rehabil Med. 2021;53:1.

    Article  Google Scholar 

  30. Navarro-Santana MJ, Sanchez-Infante J, Fernández-de-las-Peñas C, Cleland JA, Martín-Casas P, Plaza-Manzano G. Effectiveness of dry needling for myofascial trigger points associated with neck pain symptoms: an updated systematic review and meta-analysis. J Clin Med. 2020;9(10):3300.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Edwards J, Knowles N. Superficial dry needling and active stretching in the treatment of myofascial pain—a randomised controlled trial. Acupunct Med. 2003;21(3):80–6.

    Article  PubMed  Google Scholar 

  32. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point: the importance of the local twitch response. Am J Phys Med Rehabil. 1994;73(4):256–63.

    Article  CAS  PubMed  Google Scholar 

  33. Dalpiaz AS, Dodds TA. Myofascial pain response to topical lidocaine patch therapy: case report. J Pain Palliat Care Pharmacother. 2002;16(1):99–104.

    Article  PubMed  Google Scholar 

  34. Dalpiaz AS, Lordon SP, Lipman AG. Topical lidocaine patch therapy for myofascial pain. J Pain Palliat Care Pharmacother. 2004;18(3):15–34.

    Article  PubMed  Google Scholar 

  35. Hsieh LF, Hong CZ, Chern SH, Chen CC. Efficacy and side effects of diclofenac patch in treatment of patients with myofascial pain syndrome of the upper trapezius. J Pain Symptom Manag. 2010;39(1):116–25.

    Article  CAS  Google Scholar 

  36. Avrahami D, Hammond A, Higgins C, Vernon H. A randomized, placebo-controlled double-blinded comparative clinical study of five over-the-counter non-pharmacological topical analgesics for myofascial pain: single session findings. Chiropr Man Ther. 2012;20(01):7.

    Article  Google Scholar 

  37. Romero V, Lara JR, Otero-Espinar F, Salgado MH, Modolo NSP, de Barros GAM. Capsaicin topical cream (8%) for the treatment of myofascial pain syndrome. Braz J Anesthesiol. 2019;69(5):432–8.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Bendtsen L, Jensen R. Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache. Cephalalgia. 2000;20(6):603–10.

    Article  CAS  PubMed  Google Scholar 

  39. Haviv Y, Rettman A, Aframian D, Sharav Y, Benoliel R. Myofascial pain: An open study on the pharmacotherapeutic response to stepped treatment with tricyclic antidepressants and gabapentin. J Oral Facial Pain Headache. 2015;29(2):144–51.

    Article  PubMed  Google Scholar 

  40. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain-United States, 2016. JAMA J Am Med Assoc. 2016;315(15):1624–45.

    Article  CAS  Google Scholar 

  41. Busse JW, Craigie S, Juurlink DN, Buckley DN, Li W, Couban RJ, et al. Guideline for opioid therapy and chronic noncancer pain. CMAJ. 2017;189(18):E659–66.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Lynch ME, Campbell F. Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials. Br J Clin Pharmacol. 2011;72(5):735–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil. 2001;82(7):986–92.

    Article  CAS  PubMed  Google Scholar 

  44. Kamanli A, Kaya A, Ardicoglu O, Ozgocmen S, Zengin FO, Bayık Y. Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome. Rheumatol Int. 2005;25(8):604–11.

    Article  CAS  PubMed  Google Scholar 

  45. Nicol AL, Wu II, Ferrante FM. Botulinum toxin type a injections for cervical and shoulder girdle myofascial pain using an enriched protocol design. Anesth Analg. 2014;118(6):1326–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Graboski CL, Shaun Gray D, Burnham RS. Botulinum toxin a versus bupivacaine trigger point injections for the treatment of myofascial pain syndrome: a randomised double blind crossover study. Pain. 2005;118(1–2):170–5.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Physical Medicine and Rehabilitation, Department of Clinical Neuroscience, University of Calgary, Calgary, AB, Canada

    George Deng

Authors
  1. George Deng
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Otolaryngology, University of Manitoba, Winnipeg, MB, Canada

    Brian W. Blakley

  2. Winnipeg, MB, Canada

    Joan E. Blakley

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Deng, G. (2023). Myofascial Pain. In: Blakley, B.W., Blakley, J.E. (eds) Functional Illness of the Head and Neck. Springer, Cham. https://doi.org/10.1007/978-3-031-12998-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-12998-8_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-12997-1

  • Online ISBN: 978-3-031-12998-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation