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“Myo” is a Greek word for muscle. “Fascia” is the tough outer lining of a muscle that holds it in place. Myofascial pain is pain in the muscles and fascia.

Myofascial Pain

The pain feels deep, achy, tense, and sometimes sharp. When you rub or massage the painful area, you may feel painful, tight bands or “knots” in the muscle. These knots are known as “trigger points.” Pressing a trigger point in one area may cause pain at the trigger point, plus aching, or pain in a nearby area. The pain can involve a single muscle or many muscles. It may be present while you are active or when you are at rest.

Causes of Myofascial Pain

This kind of pain can have many causes.

  • Poor posture

  • Overuse of muscles

  • Injury to muscles or nearby joints

  • Injuries to the spine or to the nerves supplying a muscle

Location of Pain

Although almost any muscle can be involved, some of the most common sites of this type of pain are in the neck, shoulders, head and low back.

Treatments

Exercise:

This is the most important treatment. To reduce or get rid of myofascial pain, you can stretch the painful muscle, improve posture, and restore healthy muscle use. You will learn exercises to do at home, at work, or in the gym. If you keep exercising and keep good posture even after the pain is better, you will help prevent the problem from coming back.

Massage:

This can reduce pain by stretching the muscles and “smoothing out” trigger points. You or a partner can massage trigger points using hand pressure, a rubber ball or tennis ball, or a massage device. You will learn how to do this. Massage therapists can also help, using “myofascial release” and other techniques. The relief from massage is temporary. You will still have to exercise to keep myofascial pain under control.

Trigger point injections:

These injections use a thin needle to make trigger points relax. This is done when trigger points do not improve with other treatment. No drug is needed, as the needle itself does the work. Some providers inject an anesthetic during trigger point injection; others just use the needle (“dry needling”). By relaxing the trigger points, injections can make it easier to exercise.

Heat, cold, acupuncture, relaxation training, and biofeedback:

These therapies may also be helpful.

Pain medicines:

These can help but do not work well when used alone. The best method is to combine medicine with other treatments.

Types of Exercises

Use the exercises on your exercise guide to help relieve myofascial pain. Your provider will show you which of these is right for you. You will feel pulling or stretching as you do the stretches, but you should not have pain. Move slowly while stretching. When you finish the stretch, you should feel slightly better. If you have more pain the next day, you may have stretched with too much force or the stretch may not be right for you.

Exercise Guide

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  • 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.

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  • 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.

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  • Sit on a chair. Hold onto the chair as shown.

  • Lean your head and trunk away from the fixed arm.

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  • 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.

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  • 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.

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  • Stand or sit.

  • Push shoulders forward, stretch the arms diagonally forward and down keeping your chin in. Hold stretching 20 seconds.

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  • 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.

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  • Stand straight facing the edge of a door holding onto the door handles.

  • Bend your knees as shown and stretch your back.

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  • 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.

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  • 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.

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  • 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.