Myofascial pain syndrome involves irritation at the level of the muscles in your body. Over 44 million Americans are estimated to have this condition. This is usually found in head, neck, shoulders, extremities and back. Pain is present locally and often referred to other parts of the body that arises from trigger points which are localized sensitive areas in the muscle that contain palpable, taut bands. Most often this presents as a secondary problem after an initial insult or trauma to deeper structures of the spine. The muscles respond by contracting around the injured area and in the low back is typically referred to as a low back strain. Initially, this serves a protective benefit to decrease any activities that could potentially aggravate the pain. However, if the deeper injury does not improve and/or is not treated appropriately soon after the insult, the muscle spasms can serve to contribute to your overall pain. This can be felt as “little knots” in the muscles of your spine. Typically placing any pressure on these knots reproduces your pain. As the muscle tightens, it decreases the blood flow going to that muscle. Decreasing the blood flow leads to further muscle tightening from lack of oxygen to that muscle. This becomes a vicious cycle that can further increase your pain.
In most instances, anti-inflammatories and possibly muscle relaxants can be helpful in treating your spasms. These are not targeted at treating anything specifically but may help with the pain until your body heals. Physical therapy is recommended as this can improve your spasms utilizing different treatment modalities including: heat, ultrasound, massage, electrical stimulation, dry needling etc. Seeing a chiropractor or an acupuncturist may also help alleviate these symptoms.
However, if your pain continues, specific therapy directed at the underlying cause of your pain beyond the level of the muscles may help to alleviate your pain. Once the specific cause of your pain is treated, the muscle spasms typically improve.
If it is determined that the muscles are your primary pain generator, then trigger point injections may help alleviate some of your symptoms. This involves injecting a mixture of medications into the muscles themselves to decrease the spasm and improve blood flow. Steroids are not recommended in treating muscle spasms. As with all disease states, it is best to treat this early and aggressively as pain has memory and the longer you continue to have the pain, the more difficult it will be for your body to erase this memory.