What Causes Myofascial Pain?

How Trigger Points Are Formed

The insult to muscle and connective tissue which results in trigger points can occur several ways. It can happen as the result of:

  • Repetitive overuse injuries - using the same body parts in the same way hundreds of times on a daily basis - from activities such as texting, typing/mousing, musical fretting or keyboarding, electronic gaming, gardening, vocational tasks, etc.
  • Sustained loading as with heavy lifting, carrying babies, briefcases, boxes, wearing body armor or lifting bedridden patients.
  • Habitually poor posture due to de-conditioning, sedentary lifestyle, or poorly designed furniture
  • Poor nutrition or overuse of stimulants, particularly sugar
  • Prolonged physical or mental stress without relief
  • Prolonged cough
  • Direct injury such as a blow, strain, break, twist or tear. Think car accidents, sports injuries, falls, sprains
  • Surprisingly, trigger points can even develop due to inactivity such as prolonged bed rest or sitting, or even being born!
Trigger Points Cause Pain

After forming, trigger points range from constantly sharply painful to only mildly painful when palpated. The actively painful trigger point produces the unrelenting, debilitating pain which motivates people to seek relief. It hurts when pressed with a finger, causing pain around it as well as referred pain to other areas. It causes the muscle in which it's located to be weak and have limited flexibility. The referred pain from the active trigger point may feel like a dull ache, deep, pressing pain, burning, or a sensation of numbness, tingling, or fatigue. It can also cause sweating, watering eyes, goose bumps or dizziness. The affected muscles are dense, shortened, and contain dense nodules and taut bands that may even compress and entrap nerves, leading to a secondary set of symptoms.

If unaddressed or ineffectively treated, eventually other muscles around the dysfunctional one may attempt to "take up the slack", becoming stressed and developing secondary trigger points. It is not unusual for chronic pain patients to have multiple, overlapping referred pain patterns, making diagnosis and treatment more complex. It is easy to see why this widespread pain is often mistaken for Fibromyalgia - a related but separate diagnosis.

Trigger points can also lie quietly in muscles, relatively unnoticeable. Unless you press on these trigger points and feel the tenderness, you might not realize they are there. Most people have at least a few like this. While these trigger points generally don't cause pain unless aggravated, they do cause:

  • Restricted movement
  • Distorted muscle movement patterns
  • Stiffness and weakness of the affected muscle

They can become more noticeable or painful if aggravated by excessive compression, fatigue, infection, illness, stress, or by muscle overload or chilling.

 

“I’ve personally seen countless cases in which myofascial pain turned out to be the decisive element in chronic pain syndromes such as migraine, neuropathic pain, arthritis, and disc herniation. And time after time, when the myofascial pain was treated, the presenting problem was either eliminated or very greatly eased in frequency and severity of symptoms.”

Bernard Filner, MD, PA