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Treatment for myofascial pain syndrome typically includes physical therapy, trigger point injections or medications. No conclusive evidence supports using one therapy over another. Discuss your options and treatment preferences with your doctor. You may need to try more than one approach to find pain relief.

Physical therapy
A physical therapist can devise a plan to help relieve your pain based on your signs and symptoms. Physical therapy to relieve myofascial pain syndrome may involve:

• Stretching. A physical therapist may lead you through gentle stretching exercises to help ease the pain in your affected muscle. If you feel trigger point pain when stretching, the physical therapist may spray a numbing solution on your skin.
• Massage. A physical therapist may massage your affected muscle to help relieve your pain. The physical therapist may use long hand strokes along your muscle or place pressure on specific areas of your muscle to release tension.
• Finding causes of pain. A physical therapist can help you identify and correct factors that may contribute to your pain. For instance, if poor posture is causing muscle stress in your lower back, the physical therapist may guide you through exercises to correct your posture.

Trigger point injections
During a trigger point injection, your doctor inserts a needle into a trigger point in your muscle. The needle may be inserted into several places in and around your trigger point. Trigger point injections, sometimes called needling, may relieve the tension in your muscle that causes the trigger point.

Your doctor may inject a small amount of a numbing medication, such as an anesthetic, each time the needle is inserted. Corticosteroid medications also may be used to relieve pain and inflammation around the trigger point.

Medications
Medications may help treat the signs and symptoms of myofascial pain syndrome, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs may relieve muscle pain, though some people find they aren't helpful. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin, others) and naproxen (Aleve). Other NSAIDs are available by prescription.
• Depression medications. A class of medications for depression called tricyclic antidepressants may help relieve pain and help you sleep.

2007-11-30

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