How is myofascial pain syndrome diagnosed?

Myofascial pain syndrome is often an underdiagnosed and overlooked condition. It might be mistaken for a problem with your nerves, bones, ligaments or tendons — but it’s not. It’s a problem in your muscles.

There are no tests — no imaging tests, laboratory tests/ blood work, electromyography or muscle biopsy — that can diagnose myofascial pain syndrome. In addition, there are no visible signs, such as redness, swelling or unusual muscle warmth.

The best method your healthcare provider can use to detect this syndrome is to physically examine your muscles — to feel for the taut bands of muscles and then find the exact spots of tenderness. Finding and applying pressure to a trigger point will result in pain, felt at the immediate spot or in an area a short distance away (referred pain).

There are four types of trigger points:

  • An active trigger point typically lies within a muscle and pressure to it results in local or regional pain.
  • A latent trigger point has the potential to be active, but is dormant.
  • A secondary trigger point is located in a muscle other than the one that holds the active trigger point. It can be irritated at the same time as the active trigger point.
  • A satellite trigger point is one that becomes inactive because it overlaps with the region of another trigger point.

Questions your healthcare provider may ask to diagnose myofascial pain syndrome:

Your healthcare provider may order a few tests to rule out other conditions and ask you questions about your pain, including:

  • Where do you feel the pain?
  • How would you describe your pain?
  • How often do you experience pain?
  • What makes your pain better?
  • What makes your pain worse?
  • Have you had any recent injuries?
  • Do your symptoms get better at certain times during the day?
  • What does your work day look like (to look for activities in which there is muscle strain/repetitive motion)?

Your healthcare provider may check your gait (how you walk) and your posture to see if there is a balance of muscle use and look for signs of muscle weakness. You may also be asked about other health problems that can contribute to myofascial pain syndrome including how much and how well you sleep and if you feel stressed, anxious or depressed.

What’s the difference between myofascial pain syndrome and fibromyalgia?

Myofascial pain and fibromyalgia pain feel similar. Both have trigger points that emit pain. However, while myofascial pain is contained in one specific area (or, if more than one area, those areas are typically on the same side of the body), fibromyalgia pain is felt throughout the entire body. A patient with fibromyalgia has more trigger points, general pain, worse fatigue and sleep issues, headaches, an irritable bowel, a sensation of swelling and sometimes a burning, prickling or tingling feeling. Some researchers believe that myofascial pain syndrome can transition into fibromyalgia.

Last reviewed by a Cleveland Clinic medical professional on 07/06/2020.

References

  • National Association of Myofascial Trigger Point Therapists. Myofascial Therapy. Accessed 7/1/2020.
  • American Society of Anesthesiologists. Myofascial Pain Syndrome. Accessed 7/1/2020.
  • 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, 6e. New York, NY: McGraw-Hill; 2009. Accessed 7/1/2020.
  • Chandola HC, Chakraborty A. Fibromyalgia and myofascial pain syndrome-a dilemma. Indian J Anaesth. 2009;53(5):575-81. Accessed 7/1/2020.
  • Rodante JA, Al Hassan QA, Almeer ZS. Myofascial Pain Syndrome: Uncovering the Root Causes. 2012;12(6). Accessed 7/1/2020.
  • Weller JL, Comeau D, Otis JAD. Myofascial Pain. Semin Neurol 2018;38(6):640-643. Accessed 7/1/2020.
  • Gerwin RD. Myofascial Trigger Point Pain Syndromes. Semin Neurol 2016;36(5):469-473. Accessed 7/1/2020.
  • Academy of Nutrition and Dietetics. Can Diet Help with Inflammation? Accessed 7/1/2020.

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