Myofascial Pain Syndrome

Myofascial Pain Syndrome

1. Myofascial Pain Syndrome Ade Wijaya, MD – April 2019

2. Outline: Introduction Definition Etiopathogenesis Precipitating factors Clinical features Clinical signs Electrophysiology Management Summary

3. Introduction Underdiagnosed & undertreated Musculoskeletal pain, limited mobility, weakness, and referred pain Myofascial trigger points Prevalence: 30-93% of all musculoskeletal pain 46.1 + 27.4 % overall

4. Definition “ A noninflammatory disorder of musculoskeletal origin, associated with pain and muscle stiffness, characterized by the presence of hyperirritable palpable nodules in the skeletal muscle fibers which are termed “ Myofascial trigger points”

5. Etiopathogenesis

6. Perpetuating Factors

7. Clinical Features Acute and chronic Visceral and somatic Maybe accompanied by sensory symptoms Various symptoms

8. Clinical Signs Tender points Jump sign: pressure on the spot can cause the patient to react with a spontaneous movement or exclamation Pain reproduction: by pressure on the tender points Local twitch response: by vigorously snapping palpation on myofascial trigger points Referred pain Restricted range of motion Weakness Recruitment disruption Associated phenomena: autonomic, proprioceptive, balance and tinnitus

9. Electrophysiology Low amplitude Intermittent high amplitude Increase endplate noise intensity

10. Management Manual therapies Noninvasive nonmanual therapies Invasive therapy: dry needling, acupuncture, local anesthetic injections Medication (paracetamol, NSAIDs, weak opioids , thiocolchicoside) Indentify and treat the underlying causes or the perpetuating factors

11. Summary Myofascial pain is common Frequenty underdiagnosed and undertreated Various symptoms Myofascial trigger points Management: multimodal

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