Chronic myofascial pain (CMP), also called myofascial pain syndrome, is a painful condition that affects the muscles and the sheath of the tissue — called the fascia — that surround the muscles. CMP can involve a single muscle or a group of muscles.

What are the symptoms of CMP?

The most notable feature of CMP is the presence of trigger points. Trigger points are highly sensitive areas within the muscle that are painful to touch and cause pain that can be felt in another area of the body, called referred pain.

Trigger points might be “active” or “latent.” An active trigger point is always sore and can prevent the full use of the muscle, leading to weakness and decreased range of motion. A latent trigger point does not cause pain during normal activities, but is tender when touched and can be activated when the muscle is strained, fatigued, or injured.

Other symptoms associated with CMP include a sensation of muscle weakness, tingling, and stiffness. The pain associated with CMP might also lead to problems sleeping.

Is chronic myofascial pain the same thing as fibromyalgia syndrome?

CMP may resemble fibromyalgia syndrome (FMS) and has sometimes been referred to as “regional fibromyalgia.”  Both disorders are defined as having “tender points in muscles.” However, CMP is believed to be a disorder of the muscle itself while FMS is believed to be a disorder in the way the brain processes pain signals. FMS is usually associated with more widespread pain and other symptoms that do not affect muscles including sleep disruption, irritable bowel syndrome, fatigue throughout the body, and headache.

What causes CMP?

No one is sure what causes CMP. Possible causes include mechanical factors — such as having one leg longer than the other — poor posture, stress, and overuse of muscles. Exercising or performing work activities using poor techniques can also put excessive strain on muscles, leading to CMP. In addition, anxiety and depression can cause increased muscle tension, leading to significant myofascial pain. Trigger points might be activated by overwork, fatigue, direct trauma, and cold.

How common is CMP?

Pain originating in the muscles and fascia is very common. Nearly everyone at some point suffers from this type of pain, known as myalgia fasciitis or myofascitis. CMP, however, involves pain that is chronic, or long lasting, and is associated with specific trigger points.

CMP most often occurs in people between the ages of 30 and 60 years. It affects men and women equally.

How is CMP diagnosed?

Your health care provider usually begins with a thorough physical examination and medical history, including a review of symptoms. The provider will likely perform a detailed exam of the affected muscles, including strength and range of motion testing. He or she will rub the suspected trigger points to see if the muscles respond, or twitch, and cause pain in a predictable pattern or specific region.

Sometimes blood tests will be performed to look for medical causes of muscle pain, such as vitamin D deficiency or hypothyroidism.

How is CMP treated?

Treatment options might include:

  • Physical therapy — A therapy program includes stretching, postural and strengthening exercises.
  • MedicineNon-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, might be used to help reduce pain.
  • Massage therapy — Therapeutic massage can loosen tight muscles and relieve cramping or spasms.
  • Injections — This involves injecting a pain medicine (local anesthetic) directly into the trigger points.

It is also important to address any factors — such as poor posture, workplace ergonomics, or mechanical problems — that might be contributing to CMP pain.

What complications are associated with CMP?

In some cases, the pain of CMP can affect additional muscles. For example, a muscle can be stressed when another muscle is affected by CMP and is not functioning properly.

What is the outlook for people with CMP?

In general, the outlook is good. When properly diagnosed and treated, the pain associated with CMP often can be controlled.

Can CMP be prevented?

It might not be possible to prevent all episodes of CMP, but the following tips might help reduce their occurrence and speed recovery:

  • Improve your posture
  • Reduce your body weight
  • Exercise regularly
  • Eat a healthy, well-balanced diet
  • Learn stress-management techniques
  • Use proper techniques at work, and during exercise and sports


  • Borg-Stein J. Treatment of fibromyalgia, myofascial pain, and related disorders. Phys Med Rehabil Clin N Am. 2006 May;17(2):491-510, viii.
  • Bernstein CD, Weiner DK. Chapter 123. Fibromyalgia and Myofascial Pain Syndromes. In: Halter JB, Ouslander JG, Tinetti ME, Studenski S, High KP, Asthana S, eds. Hazzard's Geriatric Medicine and Gerontology. 6th ed. New York: McGraw-Hill; 2009.
  • Langford CA. Chapter 336. Arthritis Associated with Systemic Disease, and Other Arthritides. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.
  • Yap E-C. Myofascial Pain: An Overview. Ann Acad Med Singapore 2007;36:43-8.
  • Childers MK, Feldman JB, Guo HM. Myofascial pain syndrome. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 96.
  • Annaswamy TM, DeLuigi AJ, O’Neill BJ, et al. Emerging Concepts in the Treatment of Myofascial Pain: A Review of Medications, Modalities, and Needle-based Interventions. PM R volume 3, issue 10 (October, 2011), p. 940-961.
  • Thompson JM. Exercise in muscle pain disorders. PM R. 2012 Nov;4(11):889-93.

© Copyright 1995-2016 The Cleveland Clinic Foundation. All rights reserved.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/1/2013...#10437