Myofascial pain syndrome:
Chronic muscle pain
Definition and symptoms of myofascial pain syndrome
What is myofascial pain syndrome?
Myofascial syndrome is a chronic pain syndrome of the musculoskeletal system characterized by trigger points (TP): small areas of hyperexcitability nestled within a tense muscle cord. When stimulated—by pressure, traction, or sometimes spontaneously—these points cause local pain that can radiate to other areas.
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Doctors Janet Travell and David Simons, pioneers in the 1950s, formalized the concept of TP: a hypersensitive area within a hardened muscle, capable of triggering referred pain specific to the muscle concerned. They distinguish between:
Active TP: painful at rest or during exertion, it reproduces the typical referred pain of the muscle.
Latent TP: clinically silent until stimulated; pain only appears when provoked.
Although myofascial syndrome can be confused with other chronic conditions such as fibromyalgia, it is distinguished by the presence of genuine palpable trigger points and pain that is often more localized. Identifying the active or latent nature of these TP is essential for adapting manual treatment, stretching, and rehabilitation, thereby reducing pain in the long term.
Symptôms
The main symptoms
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Localized muscle pain: frequently felt in specific areas such as the neck, shoulders or back.
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Active trigger points: sensitive muscle areas that trigger pain when activated.
Other symptoms, although less frequent, may include :
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Muscle stiffness
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fatigue
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sleep disorders
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headaches
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Postural imbalances
Diagnosis of the Myofascial Pain Syndrome
Clinical Diagnosis
Diagnosis relies on thorough clinical evaluation, as there are no specific imaging or laboratory tests to confirm this condition.
Steps include :
Detailed history, gathering information on pain frequency, intensity, triggers and relievers
Imaging tests: if necessary, to exclude other pathologies responsible for the pain
Observation: to detect postural abnormalities and imbalances
Physical examination: look for tight muscle bands and trigger points
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Difference between Myofascial Pain Syndrome and Fibromyalgia
Although these two conditions share certain symptoms, they have fundamental differences:
Myofascial syndrome: localized, regional pain accompanied by trigger points. Once treated, the pain disappears.
Fibromyalgia: diffuse, chronic pain throughout the body. Fatigue and sleep disturbance very common.
It is possible for a person to suffer from both conditions simultaneously, making accurate diagnosis essential for appropriate treatment.
Treatment of Myofascial Pain Syndrome
Specific injection techniques
Injecting local anesthetics or corticoids into trigger points temporarily numbs the painful area, or reduces local inflammation, thus relieving immediate pain. These infiltrations are often combined with other techniques to release muscle tension and reduce inflammation.
Dry Needling
Dry needling (or “dry acupuncture”) is a treatment technique that involves inserting fine needles, similar to those used in acupuncture, directly into muscle trigger points. This method is effective in relieving muscle pain, reducing tension and improving muscle function.
Osteopathy and manual therapy
Osteopathy plays an essential role in the treatment of myofascial pain syndrome, offering a targeted manual approach to treating pain, improving muscle mobility and restoring postural balance.
The osteopath uses manual techniques to :
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Manual trigger point inhibition techniques: The osteopath helps relax muscles affected by trigger points.
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Improve blood circulation: By acting on vascularization, osteopathic manipulations promote better oxygenation of muscle tissue.
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Restore postural balance: Osteopaths can identify and correct postural imbalances that contribute to the development of myofascial syndrome.
Stretching, Mobilisation and Rehabilitation
Stretching and muscular mobilization help release tense muscles and improve flexibility. These techniques are often performed by osteopaths and physiotherapists.
Patient education and the integration of self-exercise and self-stretching help patients to better manage their pain on a daily basis and prevent recurrence of the syndrome.
Benefits of osteopathy and manual therapy in the treatment of myofascial syndrome
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Targeted therapy for trigger points release: Manual therapy techniques (ischemic inhibition pressure) applied by the osteopath directly release the trigger points responsible for referred pain, providing rapid relief from muscle contracture. This is the least invasive treatment for myofascial syndrome.
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Normalization of joint mobility: Through gentle manipulation (fascial, myotensive, and adapted HVLA techniques), osteopaths restore mobility to adjacent joints, thereby reducing the tension that maintains trigger points.
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Holistic approach to the patient: Myofascial syndrome never occurs in isolation: posture, stress, sleep disorders, and repetitive movements can all contribute to it. A qualified and experienced osteopath explores these factors to provide a tailored response to each patient.
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Therapeutic education and ergonomic advice: Advice for patients with specific stretching exercises for the affected muscle. Understanding what a trigger point is, knowing how to adjust your posture at the office, or distributing loads during sports activities are an integral part of follow-up care. This education strengthens your autonomy and reduces dependence on repeated consultations.
