Living With Myofascial Pain Syndrome

Living With Myofascial Pain Syndrome Blog  Myofascial Pain

No matter who you are, you have no doubt experienced some type of pain or muscle discomfort. If you are unfortunate enough to live with cervical myofascial pain syndrome then this type of pain can be much worse for you and is a chronic type of disorder which may result in pain throughout different areas of the body.

What Is Cervical Myofascial Pain Syndrome?

Cervical myofascial pain begins at the start of the vertebral spine in the neck area and then correlates to the surrounding fascia muscles nearby. The fascia consists of a mass of connective tissues that are responsible for supporting and binding together parts of the body as well as internal organs. Unfortunately, there are no tests that can be used in order to clinically confirm this type of syndrome.

Areas Which Are Affected From Cervical Myofascial Pain

Diagnosing myofascial pain is done by examining what are referred to as trigger points around the body. Typically, the points can be found in such muscles as the trapezius and the infraspinatus. These points may also be defined as very irritable areas located in a palpable and taut band of muscle fibers.

Observations Which May Help To Define Triggers

According to a recent review about trigger points, the following conclusions may help a doctor diagnose the syndrome.

  • Most trigger points cause localized pain.
  • Active points of myofascial pain are signs indicated from pain deriving from the response of movements. It may also come about spontaneously. This may be opposite from latent points in which no pain may be noticed until the area becomes compressed.
  • Snapping palpations might cause local twitch responses. These twitch responses are quick contractions of the fibers found around a tight band of muscles.
  • Patients who are found to have trigger points might also notice additional localized autonomic incidences such as pilomotor responses, vasoconstriction, hypersecretion, and ptosis.
  • A restricted range of motion that may be accompanied by sensitivity to muscles fibers that get stretched.
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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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