International Journal of Anesthesiology & Pain Medicine

Description

Myofascial Pain Syndrome (MPS) is a type of chronic pain syndrome that is differentiated by persistent pain in the muscles, fascia, or adjacent soft tissues. MPS symptoms include Myofascial Trigger Points (MTrP’s) and fascial constrictions. Trigger points are pain receptors that respond to stimuli, resulting in both localized and generalized pain. MPS can develop on its own or in concurrence with other disorders. Dr. Travell, an American researcher, created the phrase "myofascial pain" in 1952. Following that, doctors began to pay more attention to MPS, also known as myofascial fibrositis, myositis, fibromyositis, muscle strain, and myofascial syndrome. Currently, domestic and international researchers are unable to reach an agreement on the aetiology and pathophysiology of MPS. Due to a lack of particular laboratory symptoms and imaging data, there are no clear diagnostic criteria for MPS, making it easier to confuse with other disorders.

Because no defined diagnostic criteria for MPS exist, epidemiological studies provide a broad range of estimates. The bulk of the evidence suggests that MPS is often associated with musculoskeletal pain. MPS is a common disorder that can affect people of any age, although it is more common in elderly persons, athletes, physical labourers, and sedentary jobs. MPS affects from 30.0 percent to 93.0 percent of people suffering from musculoskeletal discomfort. Physical investigations indicate active MTrP’s (Myofascial Trigger Points) in around 46.1 percent of the patients. Clinical research has indicated that activated trigger points in sore muscles generate at least 40.0 percent of skeletal muscular pain syndrome. MPS preferred locations include the neck, shoulders, and back. At the moment, the prevalence of chronic pain caused by trigger points is growing year after year. Patients with MPS have continuous discomfort, and their range of motion is always reduced.

MPS's etiology is not totally known. Aseptic inflammation of the muscles and fascia may result in adhesion. The pain of MPS is now thought to be caused by an algogenic chemical in the inflammatory environment stimulating sensory neurons and compressing inflammatory edema tissues. MPS is most common in those who do persistent low-level static exertions, such as office workers, musicians, dentists, and others. A blood circulation problem of the skin is caused by the residual tension created by the constant static force of long-term uncomfortable working position. As a result, metabolites accumulate and excite peripheral nerve terminals, resulting in sensory nerve dysfunction such as referred pain diffusion, hyperalgesia, and allodynia. Simultaneously, sympathetic nervous system activation induces vasoconstriction of cutaneous blood vessels and a reduction in blood flow, resulting in a vicious cycle.

There are two types of reasons for the development of MTrP: Predisposing factors and risk factors.

• Acute muscular injury or persistent muscle spasms; mental stress, over fatigue, or inadequate sleep; and intense cooling of muscles are all risk factors.

• Hormonal changes and metabolic deficiencies, such as (1) Hypothyroidism and menopause; (2) nutrient insufficiency, such as vitamin B and iron deficiency; (3) chronic infection; (4) local chronic instability of biomechanics; and (5) immune diseases.

According to traditional Chinese medicine, this disease is mostly caused by muscle strain, wind-cold dampness, meridian obstruction, and blood obstruction.

Patients should be educated about the causes, management, and outlook for this type of pain. Patients should be urged to actively treat MPD, reduce dread of the disease, actively participate with medical care, and eradicate pain trigger sites as soon as possible using the above complete therapy. The keys to early MPS recovery are early therapy, healthy living habits, and scientific and standardized exercise.