Treatment of myofascial pain syndromes

Robert D. Gerwin, Jan Dommerholt

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The treatment of persons with myofascial pain syndrome (MPS) follows the general principles that apply to all medical disorders. The nature of the pain problem first must be understood through developing an appropriate differential diagnosis and evaluating the contributions of coexisting disorders, until a single working diagnosis emerges. Following the initial assessment and formulation of diagnostic hypotheses, new data are collected. A regular review at each encounter and modification of the hypotheses facilitate a more efficient and effective management of patients with MPS and dictate the actual program components (Higgs & Jones, 1995; Jones, 1994). After addressing the issue of diagnosis, the practitioner must determine the structural or biomechanical functioning of the patient and the contribution that any dysfunction may have to the individual’s pain. Medical and psychological disorders that may alter the presentation of MPS or that may predispose to its becoming chronic are assessed. Treatment of persons with MPS addresses each of these issues specifically (Figure 21.1). There must be relief of pain by the direct inactivation of the myofascial trigger point (MTrP) itself. The mechanical and structural factors that affect or overload the muscle and aggravate the pain must be resolved or alleviated. The medical and psychological problems that affect muscle function, including those that alter and impair intracellular metabolism, must be identified and corrected where possible. Inactivation of the MTrP may occur with direct intervention at the MTrP itself, through correction of the mechanical factors that produced it or through improvement in the underlying medical disorders that predispose to the development or maintenance of the MTrP.

Original languageEnglish (US)
Title of host publicationPain Management
Subtitle of host publicationA Practical Guide for Clinicians, Sixth Edition
PublisherCRC Press
Pages235-249
Number of pages15
ISBN (Electronic)9781420093193
ISBN (Print)0849309263, 9781420038927
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Health Professions(all)
  • Medicine(all)

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  • Cite this

    Gerwin, R. D., & Dommerholt, J. (2001). Treatment of myofascial pain syndromes. In Pain Management: A Practical Guide for Clinicians, Sixth Edition (pp. 235-249). CRC Press.