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Myofascial Syndrome

Myofascial: from the Greek myelos, meaning marrow (muscle) and from the Latin fascia meaning bandage or band

Myofascial syndrome (MFS) is a musculoskeletal condition characterized by painful foci of muscle called trigger points (TrPs). MFS became better known based on the work of Dr. Janet Travell, a White House physician for many years.

MFS has often been confused with fibromyalgia because they both involve muscle pain. Trigger points of MFS differ from tender points of fibromyalgia in that they may be just about anywhere, whereas the tender points of fibromyalgia are in a specified pattern. When a physician presses on a tender point in fibromyalgia patients, they describe exactly that--tenderness. When a physician pushes a trigger point in MFS, the trigger point elicits an involuntary "twitch" response. Additionally, the patient may experience referred pain (ie, pain that radiates to an area away from the trigger point itself). The painful trigger point area is in the muscle or junction of the muscle and fascia. Hence, myofascial pain is usually associated with a taut band, indicating a "ropey" thickening of muscle tissue.

The fascia is a tough connective tissue that spreads throughout the body in a three-dimensional web from head to foot without interruption. The fascia surrounds every muscle, bone, nerve, blood vessel, and organ of the body, all the way down to the cellular level. Therefore, malfunction of the fascial system due to trauma, posture, or inflammation can create a "binding down" of the fascia, resulting in abnormal pressure on nerves, muscles, bones, or organs.

Much of the pain that accompanies MFS is due to inadequate blood flow to the trigger point area (ischemia) that inhibits the ability of the muscle to eliminate metabolic wastes (eg, lactic acid and potassium). These accumulated metabolic byproducts combined with inadequate oxygen flow to the affected area then build up, stimulating nearby nerve endings that lead to trigger point pain.