Myofascial pain syndrome

The myofascial pain syndrome is a disease that is characterized by musculoskeletal pain, which do not originate from joints, periosteum, muscle disorders or other neurological diseases. In contrast to the MSS fibromyalgia is always in front of a localized pain condition.

Cause

Myofascial pain syndrome, the cause is a more sensitive to focus in a muscle, which is referred to as the trigger point. It is caused by overloading of a muscle that leads to a sustained contraction of individual sarcomeres. This leads to a localized oxygen deficiency or inhibition of reuptake of calcium into the sarcoplasmic reticulum and thus a sustained contraction. This Kontrakturknoten is usually palpable. The release of neurotransmitters leads to pain, which may extend through spinal reflexes to adjacent muscle districts.

Starting point for muscle overload may be ( damage to individual nerve roots ) stress, smallest damage caused by repetitive movements, malnutrition, hormonal disorders, immobility, muscle weakness, seizures, or neurological damage. Even a sub- cooling (eg to thin clothes in winter) can lead to the development of trigger points.

Clinical features and diagnosis

It is characterized by a local pressure-sensitive point, a hard strained muscle bundles and a radiating pain (muscle myogelosis, band thawed ) in the so-called transfer zone at pressure to the trigger point. When pressure on the trigger point there is a reflex twitch muscle fibers of the local (local twitch response LZR ). In addition, there is limited mobility and muscle weakness of the area. A stretching of the muscle is due to pain limited.

If the pain when exercising the pressure follows a dermatome, then it is not a trigger point. So you can always trigger points clearly distinct from neurological causes.

Muscle myogelosis and reflexive twitch absent in the tender points of fibromyalgia, however, occur in 70% of fibromyalgia patients simultaneously MSS trigger points on.

Treatment

The treatment is mainly through physical therapy (trigger point therapy, massage). Heat treatments such as Natural mud, red light or a Körnerkissen can also have a positive influence in the connection to the actual therapy by stimulating the metabolism.

For complicated shapes muscle relaxants can be used as Tetrazepam, flupirtine, Tolperisone or methocarbamol. In treatment- resistant forms takes place invase treatment by infiltration of the trigger point. A hollow needle will be demonstrated in the trigger point and back and pushed back (dry needling ), optionally isotonic saline, a local anesthetic or botulinum toxin are injected.