Myofascial pain

MFP is a regional muscle pain disorder characterized by localized

muscle tenderness and pain and is the most common cause of

persistent regional pain. The affected muscles may also

display an increased fatiguability, stiffness, subjective

weakness, pain on movement and slightly restricted range of

motion that is unrelated to joint restriction. MFP is

frequently overlooked as a diagnosis because it is often

accompanied by signs and symptoms in addition to pain,

coincidental pathological conditions, and behavioural and

psychosocial problems. Chronic pain characteristics often

precede or follow the development of MFP. Evaluation of MFP

includes locating the trigger points and muscles involved as

well as recognition of the contributing factors. Management of

the syndrome naturally follows with muscle exercises, therapy

to the trigger points, and reduction of all the contributing

factors. The short-term goal is to restore the muscle to

normal length and posture and full joint range of motion with

exercises and trigger point therapy. The long-term goals

include reducing the symptoms and their negative effects while

helping the patient return to normal function without the need

for future health care. The difficulty in managing MFP lies in

the critical need to match the level of complexity of the

management programme with the complexity of the patient’s

situation. Failure to address the entire problem, through a

team approach if needed, may lead to failure to resolve the

pain and perpetuation of a chronic pain syndrome.

Fricton JR

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