Myofascial Pain (Muscular) Explained

Millions of Americans suffer from myofascial pain.

by Sanjay Trivedi, M.D.

Studies show that many back pains, neck pains, headaches, shoulder pains, arm pains, postural pains, etc. are caused by injured fascia—a connective tissue that covers our muscles. The areas where this injury is, are called Myofascial Trigger Points (MTrPs), and are located within taut bands of skeletal muscle fibers. They are thus called because they cause pain not only to the specific location, but also to other parts of the body, when touched or pressed even lightly.

Myofascial PainInjuries to the fascia may be generated from accidents, a lack of activity, and some medical conditions. When myofascial pain becomes acute, or develops into chronic pain, Myofascial Pain Syndrome (MPS) can occur.


Treating the underlying etiologic lesion responsible for MTrP activation is the most important strategy in MPS therapy. If the underlying pathology is not given the appropriate treatment the MTrP cannot be completely and permanently inactivated.

Treatment of active MTrPs may be necessary in situations in which active MTrPs persist even after underlying etiologic lesion has been treated appropriately. When treating the active MTrPs or their underlying pathology, conservative treatment should be given before any aggressive therapy.

Effective MTrP therapies include: manual therapy, myofascial release with manual therapy, physical therapy, modalities, dry needling, or MTrPs trigger point/tender spot injections, which can be performed using various type of corticosteroids or other alternative/natural injectable medications and their combinations.

Use of oral anti-inflammatory pain medications, topical anti-inflammatory cream/gels, muscle relaxers, and depending on severity of pain—occasional short term use of narcotic medications, can help to alleviate pain.

It is also important to eliminate any perpetuating factors and provide adequate education and home treatment programs, including stretching and other exercises, and the use of hot or cold packs as needed.

Dr. Sanjay Trivedi

Author: Dr. Sanjay Trivedi

Sanjay Trivedi, M.D. received training in general surgery from Seton Hall University in New Jersey, and studied physical medicine and rehabilitation at Kingsbrook Jewish Medical Center and David Minkin Rehabilitation Institute in Brooklyn, New York. Dr. Trivedi's expertise is in the fields of acute and chronic spinal pain management, acute and chronic pharmaceutical pain management, musculoskeletal and joint pain management, and personal injury rehabilitation and care.

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