Myofascial Syndrome: Causes, Symptoms, Diagnosis, Treatment and Prevention

Generally, this syndrome appears after the repeated contraction of a muscle, caused by repetitive movements or muscle tension related to stress.

The myofascial syndrome is chronic pain and muscle type.

Typically the myofascial syndrome involves the muscles in areas of the body that are asymmetric or focal; the pressure exerted on the painful points generates pain in some parts of the body that are not related, which is called deferred pain.


The cause of myofascial syndrome is unknown.

However, it may be related to biomechanical factors of muscle overuse and in the case of repetitive microtrauma, which seems to cause a dysfunction of the motor plate due to excessive release of acetylcholine.

There are underlying conditions such as depression, previous injuries, poor sleep patterns, and stressful life situations that can play an essential role in the incitement and exacerbation of myofascial pain syndrome.

Symptoms of myofascial syndrome

The myofascial syndrome causes chronic localized muscle pain accompanied by sensitivity and spasms.


The affected muscles produce pain in the neck, upper part, and the back, just in its lower part, generally involving only one side of the body or more intensity.

It is common for patients with myofascial pain syndrome to have contraction knots in a muscle and poor sleep patterns due to pain and daytime fatigue.

It can also present other symptoms associated with lack of sleep, such as fatigue, loss of appetite, irritability, or depression.


The disease is diagnosed from a complete physical study based on:

  • Palpate painful muscle points.
  • Evaluate the reflexes.
  • Examine mobility in muscles.
  • Record any asymmetry present in the body or the adoption of wrong postures.
  • Analyze the strength of the muscles.
  • Explore stress levels.

In order not to confuse myofascial syndrome with fibromyalgia, it must be differentiated since the pain in fibromyalgia involves many areas of the body (more than eleven pain points).

It appears gradually; it may persist over time and cause developmental disability in the patient, unlike the myofascial syndrome, where the pain occurs suddenly.

The pain points are located, usually moderate, and the disability is temporary.

Laboratory tests are usually unnecessary.

Treatment of the myofascial syndrome

There are various treatment options, the main objective being pain control providing relief of symptoms, and improving the individual’s quality of life.

This treatment of myofascial syndrome can be multiple approaches that involve patient education, stress reduction, physical rehabilitation, stretching therapies, and exercise programs.

All this can help improve sleep and relieve muscle tension.

The drugs used to treat myofascial pain syndrome are directed toward several of the symptoms of the patient’s condition and can be prescribed on a temporary or long-term basis.

The medications used to seek the best treatment for a particular patient:

  • Prescription of trazodone (Serzone) or amitriptyline (Elavil) is used at bedtime and improves sleep and relieves pain.
  • Prescription of cyclobenzaprine (Flexeril) or orphenadrine (Norflex) is used at bedtime to relax muscles and help you fall asleep.
  • Prescription of antidepressants such as sertraline (Zoloft), fluoxetine (Prozac), and duloxetine (Cymbalta).
  • Prescription gabapentin (Neurontin) and pregabalin (Lyrica) can control pain and anxiety disorders.
  • Prescription of Ibuprofen (Motrin, Advil), paracetamol (Tylenol), or naproxen (Aleve) may be beneficial in relieving pain symptoms.

Other treatment options for myofascial pain syndrome and physiotherapy and drug administration are localized injections at the painful point.


  • Elongation and relaxation exercises: By performing these exercises periodically, pain is reduced, and stress can be controlled with relaxation exercises, with techniques such as slow, deep breathing, and meditation.
  • Heat Therapies: Moist heat helps relieve muscle tension and pain, increasing blood circulation and relaxing muscles.
  • Digitopression: It is based on pressing with the fingers the critical points of the skin.
  • Kinesioterapia: Different practices are performed from massage therapy, myofascial induction, manipulative articulatory techniques, and postural education, among others.

The myofascial pain syndrome should be guided by a single doctor monitoring the response to the various therapies used.

Prevention of myofascial syndrome

Myofascial pain syndrome can not be prevented, but it is possible to avoid the risk factors that worsen the condition.

These include avoiding muscle injuries, maximizing optimal sleep, minimizing stress and anxiety, and treating any underlying depression.