Chronic Myofascial Pain (CMP)

Overview

What is chronic myofascial pain (CMP)?

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.

Is chronic myofascial pain (CMP) the same thing as fibromyalgia syndrome?

No, but CMP may resemble fibromyalgia syndrome (FMS) Since 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.

How common is chronic myofascial pain (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.

Symptoms and Causes

What are the symptoms of chronic myofascial pain (CMP)?

The most notable feature of CMP is the presence of trigger points. These trigger points or “tender 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, subsequently 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.

What causes chronic myofascial pain (CMP)?

No one is sure what causes CMP. Possible causes include:

  • Mechanical factors, such as one leg longer than the other
  • Poor posture, stress and overuse of muscles
  • Exercise (overexercise, poor techniques that may lead to stress on muscles)
  • Performing work activities using poor techniques that can lead to repetitive stress injuries
  • Anxiety and depression which can cause increased muscle tension, leading to significant myofascial pain

Trigger points might be activated by overwork, fatigue, direct trauma and cold.

Diagnosis and Tests

How is chronic myofascial pain (CMP) diagnosed?

Your healthcare 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.

Management and Treatment

How is chronic myofascial pain (CMP) treated?

Treatment options might include:

  • Physical therapy: A therapy program includes stretching, postural and strengthening exercises.
  • Medicine: Non-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.
  • Workplace ergonomics: You can adapt your workspace to minimize strain (such as adjusting chair and monitor, taking breaks to stretch and reposition).
  • 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 or mechanical problems — that might be contributing to CMP pain.

What complications are associated with chronic myofascial pain (CMP)?

In some cases, the pain of CMP can affect completmentary muscle groups. For example, a muscle can become stressed by bearing a greater load when another muscle is affected by CMP and is not functioning properly.

Prevention

Can chronic myofascial pain (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

Outlook / Prognosis

What is the outlook for people with chronic myofascial pain?

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

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