ANKLE PAIN
CARPAL TUNNEL SYNDROME
CHRONIC PAIN
ELBOW PAIN
HIP PAIN
IMPAIRMENT & DISABILITY
KNEE PAIN
MUSCLE WEAKNESS
MYOFASCIAL PAIN
NECK & LOW BACK PAIN
NUMBNESS
SHOULDER PAIN
WRIST PAIN
BIOGRAPHY
REFERALS
Spence Rehabilitation Center
1650 45th Ave. Suite 2C
Munster, IN 46321
Visit our Porter County location!
1620 Country Club Rd. Ste E
Valparaiso, IN 46383
Phone : (219) 513-2267
 
     
 
What is it? 
Tight, hypersensitive muscle that is painful to touch.
How is it different from Fibromyalgia?
Myofascial pain commonly affects certain muscle groups
while fibromyalgia is more widespread and typically
accompanied by fatigue and sleep problems.
What causes myofascial pain?
Often the exact etiology is unclear and can be caused by
a variety of factors. If the pain is persistant and not
responsive to conservative treatments, further diagnostic
workup may be indicated. Contributors to myofascial pain
can include:
 
1. Joint disorders such as facet arthritis and osteoarthritis.
2. Inflammatory disorders such as rheumatoid arthritis,
polymyalgia rheumatica, and lupus.
3. Radiculopathies which are pinched nerves at the spine
level.
4. Degenerated disks in the spine can sometimes bulge
out or herniated and touch the spinal cord or nerve
roots nearby.
5. Common musculoskeletal disorders such as tendinitis
and bursitis of the joints.
6. Mechanical issues such as unsafe bending, uneven leg
length, and poor posture.
7. Nutritional deficiencies such as Vitamin B1, B12, folic
acid, iron, magnesium.
8. Endocrine problems such as low thyroid hormone.
9. Psychologic disorders including depression and anxiety.
10. Infections such as hepatitis and viral syndromes.
11. Fibromyalgia.
 
 
What are some Nonpharmacologic Treatment
options for Myofascial Pain?
 
1. Posture training:
Typically reviewed by physical therapists. Also, an
ergonomic assessment can be helpful which used to
determine what your daily work activities are and
whether job modification strategies can help.
2. Stress reduction:
Meditation, biofeedback, and relaxation techniques
can be taught by certain health clubs and pain centers.
3. Transcutaneous electric nerve stimulation
(TENS):
A device that provides a low level stimulation to block
pain going to the brain. The etiology is unclear but is
believed to be due to stimulation of certain receptors
that then interfere with transmission of pain receptors.
Another theory is that serotonin and dopamine levels
are increased which help to decrease pain.
4. Massage:
Has been found to decrease both neck and low back
pain. Stretching exercises should also be included
In the regimen.
5. Trigger point Injections:
Can be used to break the pain cycle and help to reset
the hypersensitive muscles. Injections typically include
anesthetic agents such as lidocaine with or without a
low dose of steroid. Some studies even demonstrated
that dry needling (no medication) and Botox can be
helpful. Because trigger point injections are often used
to treat chronic pain, it is sometimes necessary to
perform a series of injections to get optimal effect. The
injections are typically performed in two to three week
intervals. However, if the pain has not responded after
three rounds, it should be considered that there may
be some other factor that needs to be assessed
further.
6. Acupuncture has been shown to be beneficial under
certain conditions.
 
 
What pain medications have been found to be
useful for Myofascial Pain?
1. Nonsteroid anti-inflammatory medications:
When used with an antidepressant or muscle relaxant.
2. Tramadol:
Also known as Ultram that prevents reuptake of Serotonin
and Norepinephrine. It has some opiate like properties
so it can be habit forming and should be used
carefully.
3. Antidepressants:
Such as tricyclics and SNRIs have been found to be
helpful in decreasing myofascial pain. Commonly
prescribed TCAs and SNRIs include Amitriptylene,
Cymbalta, and Effexor.
4. Anticonvulsants:
Such as Gabapentin and Lyrica are sometimes used for
both myofascial pain and fibromyalgia.
5. Alpha adrenergic agonists:
Such as Tizanidine also known as Zanaflex can be tried.
This medication works at the level of the spinal cord to
reduce the release of aspartate, glutamate, and
substance P.
 
 
     
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Please consult a physician for medical advice regarding any medical condition."
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