What is Myofascial Pain Syndrome?

Do you have a hard knot in your back, neck, or shoulder? These spots, which cause intense pain when pressed and spread this pain to other parts of the body, are commonly known among the public as “muscle knots,” but are referred to in medical literature as Myofascial Pain Syndrome (MPS).

This clinical picture is seen in the vast majority of patients who apply to physical therapy clinics with complaints of chronic pain. This condition, which lowers the quality of life, disrupts sleep patterns, and leads to restricted movement, can last for years if not diagnosed correctly. So, why does myofascial pain syndrome occur, and is it possible to get rid of these pains permanently? Here is a detailed guide on muscle rheumatism.

What is Myofascial Pain Syndrome (MPS)?

Myofascial Pain Syndrome is a chronic pain disorder occurring in the skeletal muscles and the thin layer of membrane (fascia) surrounding these muscles. The most prominent feature of this syndrome is the hard nodules called “trigger points,” which form within the muscle fibers and create sensitivity when touched.

When pressure is applied to these points, discomfort is felt not only in that area but also in distant regions where the pain spreads; this is called “referred pain.” Unlike normal muscle pain, the pain in this syndrome does not go away with rest and, over time, causes the muscle to shorten and lose its flexibility.

What causes it? What are the risk factors?

It is difficult to identify a single cause for the development of myofascial pain syndrome; it is usually created by a combination of mechanical strain and environmental factors. Especially the inactivity and stress brought by modern life lead to the muscle fibers remaining constantly tense, paving the way for the formation of trigger points.

The primary factors that trigger the disease, lead to micro-traumas in the muscles, or cause the pain to become chronic are as follows:

• Posture Disorders: Leaning forward, sitting incorrectly at the computer, and a hunched posture, which are common among office workers.
• Repetitive Movements: Professions that constantly work the same muscle group, heavy lifting, or sports performed with the wrong technique.
• Stress and Anxiety: Psychological tension causes the body to keep the muscles constantly contracted as a defense mechanism.
• Inactivity: Not exercising regularly leads to the muscles weakening and losing flexibility, resulting in quicker injuries.
• Vitamin Deficiencies: Especially Vitamin D, B12, iron, and folic acid deficiencies can trigger pain by disrupting muscle metabolism.

Symptoms of Myofascial Pain Syndrome

The symptoms of this syndrome can vary from person to person, but the most characteristic finding is persistent pain felt in the relevant muscle group that does not respond to classic painkillers. Patients usually describe the pain as “as if there is a knot inside” or “like a stabbing sensation,” and this situation can seriously restrict their daily movements.

The most common clinical symptoms experienced by individuals with myofascial pain syndrome are:

• Deep, aching, throbbing, and sometimes burning pain in the muscles.
• Hard lumps (muscle knots) within the muscle tissue that are palpable and painful when pressed.
• Significant weakness in the affected muscle, quick fatigue, and limitation in the range of motion.
• Sleep disorders developing due to pain, waking up tired in the morning, and general malaise.
• Tension-type headaches (especially originating from trigger points in the neck and back muscles).

How is Myofascial Pain Syndrome treated?

The treatment of myofascial pain syndrome should be planned individually according to the severity of the disease and how long it has been ongoing. The primary goal of treatment is not just to stop the immediate pain but to permanently eliminate the “trigger points” causing the pain and restore muscle function.

The most commonly applied treatment methods with proven scientific efficacy and high success rates are:

1. Physical Therapy and Exercise

This is the most important and permanent step of the treatment. Stretching exercises performed under the guidance of a physiotherapist provide relief by lengthening the muscle. Additionally, exercises that correct posture, hot-cold applications, and physical therapy agents such as ultrasound and TENS are used to relax the muscles.

2. Dry Needling

It is one of the most popular and effective treatment methods of recent years. Very fine acupuncture needles that do not contain medication are inserted directly into the trigger point (knot). This process ensures the release of contracted muscle fibers, increases blood flow in the region, and provides rapid relief by activating the body’s own healing mechanism.

3. Massage Therapy

Deep tissue massage and trigger point massage (ischemic compression) applied by expert hands help open the knots in the muscles. Massage facilitates the removal of accumulated toxic substances by increasing lymphatic circulation in the region.

4. Injection Methods

In cases resistant to physical therapy, interventional methods may come into play. Local anesthetic substances, saline, or sometimes steroid injections can be made into the trigger points to provide nerve blockage and break the pain cycle.