MYOFASCIAL PAIN

MFP is a regional muscle pain disorder characterized by localized muscle tenderness and pain and is the most common cause of persistent regional pain. The affected muscles may also display an increased fatiguability, stiffness, subjective weakness, pain on movement and slightly restricted range of motion that is unrelated to joint restriction. MFP is frequently overlooked as a diagnosis because it is often accompanied by signs and symptoms in addition to pain, coincidental pathological conditions, and behavioural and psychosocial problems. Chronic pain characteristics often precede or follow the development of MFP. Evaluation of MFP includes locating the trigger points and muscles involved as well as recognition of the contributing factors. Management of the syndrome naturally follows with muscle exercises, therapy to the trigger points, and reduction of all the contributing factors. The short-term goal is to restore the muscle to normal length and posture and full joint range of motion with exercises and trigger point therapy. The long-term goals include reducing the symptoms and their negative effects while helping the patient return to normal function without the need for future health care. The difficulty in managing MFP lies in the critical need to match the level of complexity of the management programme with the complexity of the patient's situation. Failure to address the entire problem, through a team approach if needed, may lead to failure to resolve the pain and perpetuation of a chronic pain syndrome. © 1994 Baillière Tindall.