Myofascial Pain
“Myo” is a Greek word for muscle. “Fascia” is the tough outer lining of a muscle that holds it in place. Myofascial pain is the term used to describe pain in the muscles or fascia.
This pain is a deep, aching, spreading, and sometimes sharp pain in muscle. When you rub or massage the painful area, you may feel a painful, tight band or “knot” in the muscle. These knots are known as “trigger points” because pressing on them can “trigger” more pain. This pain can be right at the knot or it may spread to other nearby areas of the body. For instance, pressing a trigger point at the top of the shoulder may cause both shoulder pain and an aching, painful feeling in the upper arm.
This kind of pain can have many causes. Poor posture, overuse of muscles, and injury to muscles or nearby joints can all cause muscle pain and lead to trigger points. Sometimes trigger points come from injuries to the spine or to the nerves supplying a muscle. This pain can involve a single muscle or many muscles. It may be present while you are active or when you are at rest. Although almost any muscle can be involved, some of the most common sites of this pain are the neck, shoulders, head, and low back.
There are two main types of treatment for pain. The first and most important treatment is exercise. To reduce or get rid of myofascial pain, you can stretch the painful muscle, improve posture, and restore healthy muscle use. Your health care team will teach you exercises that you can use at home to stretch the muscles and relieve your pain. If you keep exercising even after the pain is better, you will help prevent the problem from coming back.
The second type of treatment lessens pain at the trigger points themselves. Ice, moist heat, and massage can be very helpful. If a trigger point is very painful, your doctor may use a thin needle to inject it. This helps to make the “knot” smaller and makes it less painful so that you can exercise better. Acupuncture, relaxation training, biofeedback, and other treatments may also be helpful. Pain medicines can help too, but they do not work as well when used alone. To combine treatments is the best way to treat this pain.
The exercises on the next pages may be useful in helping relieve some of this kind of pain. Your doctor will show you which of these is right for you or show you different ones that will be helpful. During these movements, you should sense a pulling or stretching feeling, but this should not be painful. Move slowly and with care during the stretching. When you finish the stretch, you should feel slightly better. You should not have more pain on the next day. If you do have more soreness on the next day, you may have stretched with too much force or the stretch may simply not be right for you
Sit with your hands clasped behind your head.
Bend your head forward until you feel a stretch in the back of your neck. Gently pull your head further forward. Hold about _____ seconds.
Repeat _____ times
Sit holding your hands together behind your back.
Tilt your ear toward your shoulder and raise your chin towards the ceiling. This will stretch the other side.
Repeat _____ times.
Sit on a chair. Hold onto the chair as shown.
Lean your head and trunk away from the fixed arm.
Repeat _____ times.
While exhaling, push your upper ribs down with your hand and lift your head away while at the same time rotating your head towards the muscle to be stretched.
Repeat _____ times.
Sit on a chair with your legs apart.
Bend your head and trunk down between your knees rounding your upper body as much as possible. Hold about 20 seconds.
Stand or sit
Push shoulders forward, stretch the arms diagonally forward and down keeping your chin in. Hold stretching 20 seconds.
Repeat _____ times.
Stand
Put one arm out to the side away from your body with the elbow straight as shown. Stretch the fingers toward the floor and drop the shoulder. Gradually stretch your head sideways away from your outstretched arm. Hold _____ seconds.
Repeat _____ times.
Stand straight facing the edge of a door holding onto the door handles.
Bend your knees as shown and stretch your back.
Stand straight with one hand on your hip and the other straight up.
Bend to the side with opposite arm reaching overhead. Keep your pelvis in mid-position.
Repeat _____ times.
Lie with your knees bent and feet on the floor. Lift your knees towards your chest.
Place your hands behind both knees and draw them towards your chest. Hold _____ seconds.
Repeat _____ times.
Lie on your back with one leg bent.
Bring your bent knee over the other leg and push your knee against the floor with the opposite hand. Then, reach with the other arm to the opposite side looking in the same direction. You will feel the stretching in your lower back and bottom. Hold about 20 seconds - relax.
Repeat _____ times.
References: Faries J, Stanton M. Myofascial pain syndromes. In McCaffery M, and Pasero C. Pain: Clinical Manual 2nd Ed. Mosby 1999; pgs 568-572.
Hanten WP, Olson SL, Butts NL, Nowicki AL. Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points.
Exercises and graphics used with permission of PhysioTools Ltd, Tampere, Finland
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 03/05/2010
Copyright © 03/05/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5934
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