Conditions of the Spine

The fascia is the tough connective tissue spread throughout the body that covers muscles, bones, nerves and organs. Myofascial Pain Syndrome (MPS) is characterized by the development of “trigger points,” or sensitive, painful areas in the muscle, or the junction of the muscle and fascia. The causes are not clearly known, however, there are some factors that may be related to the development of MPS. These factors include:

-Sudden trauma to muscles, ligaments or tendons
-Injury to discs
-Repetitive motions
-Lack of physical activity
-Nervous tension or stress
-Chilling of areas of the body such as from sitting under an air conditioner duct
-Poor posture

Diagnosis is made by a careful history and a physical exam. Specifically, the doctor may ask you about recent activities or accidents that may have precipitated the onset of symptoms. While there are no lab tests or imaging studies (x-rays, CT scans, MRIs) that can confirm the diagnosis, these tests may be done to rule out other medical problems that may be causing the symptoms.

Myofascial Pain Syndrome is often difficult to manage because myofascial pain can occur in association with many other conditions. For example, a whiplash trauma or an overuse injury from athletics can cause myofascial pain secondarily, which then persists after the original injury has healed. In other cases, the pain persists simply because the diagnosis of MPS is never made.

People who are sedentary, or only mildly active may be more likely to develop MPS. Conversely, athletes who perform repetitive movements such as serving in tennis, or a baseball pitcher with poor technique may develop myofascial pain. People with poor posture can increase strain on their spine and supportive muscles, sometimes resulting in myofascial pain. In addition, leg length differences can lead to significant myofascial back pain. Poor work design and habits such as a receptionist cradling a phone all day, or a construction worker lifting heavy loads can cause stress leading to MPS.

There are a number of approaches that may be used, and often, a combination of these treatments may be the most helpful in obtaining relief. Some of the most common treatments include:

-Exercise – Can help to reduce pain.
-Physical Therapy and Massage – May help stretch the fascia of the muscles.
-Heat/Cold Therapy – In some cases may decrease trigger point sensitivity.
-Medications
-Stretch and Spray – Passive stretching of the target muscle while applying a vapo-coolant spray.
-Trigger Point Injections – A mixture of anesthetic and steroids. These injections only provide temporary relief of pain.