What is Cervical Myofascial Pain?
Myofascial pain is a common pain disorder that affects your muscles and the connective tissues surrounding them, known as the fascia. This condition can cause discomfort in either a specific muscle or a broader area of your body. It’s often associated with multiple trigger points – certain points in your muscles that are ultra-sensitive and can cause pain in nearby regions when touched. More often, this condition can affect muscles in your neck and shoulders, such as the rhomboids, trapezius, levator scapulae, supraspinatus, and infraspinatus. The pain can either be short-term or persist over a longer period, and it’s usually brought on by over-exertion, changes in posture, or injury to a muscle.
What Causes Cervical Myofascial Pain?
The exact reasons behind myofascial pain syndrome, which is pain in the muscles and the tissue that surrounds them, are not entirely clear. However, it’s thought that using the neck muscles too much, injuring them, experiencing lots of stress, or maintaining poor posture can all contribute to muscle pain in the neck.
There are many different situations that could lead to this kind of muscle pain. For example, someone could get it from being in a car accident, from doing an activity that involves continually reaching overhead like painting a ceiling, or from working at a desk all day with a bad setup for using their computer. There are also some diseases that affect the body’s connective tissues, which can cause myofascial pain syndrome.
Risk Factors and Frequency for Cervical Myofascial Pain
Myofascial pain, or muscle pain, is quite a common condition, and it is one of the main reasons people go to the doctor not only in the United States but also around the world. In fact, it’s likely that most people will have at least one trigger point, or a sensitive spot in their muscle, at some point in their lives. This condition is particularly common among orthopedic clinic patients and those undergoing pain management treatment, affecting as many as 20% and over 80% of these groups respectively.
- The neck area is a particularly common site of myofascial pain.
- While anyone can have it, it is more common in women than in men.
- This condition generally becomes more common as a person moves through middle age, but the occurrence reduces after middle age.
Signs and Symptoms of Cervical Myofascial Pain
Cervical myofascial syndrome is a condition that has a wide range of presentations. Some people might have a history of acute trauma, while others may just experience sudden onset of pain. The discomfort may increase with repetition of tasks, specific movements, or certain postures throughout the day. The pain can persist or occur suddenly, and it may stay in one area or spread from the neck to surrounding regions.
People with this syndrome might also have restrictions in neck movements and experience pain when trying to move their neck. They can feel tightness or muscle twitching similar to spasms. The affected area typically feels tender and can be described as a deep, constant pain.
- History of trauma or sudden onset of pain
- Pain increases with certain tasks, movements, or postures
- Persistent or sudden pain
- Pain may be localized or spread from the neck to nearby areas
- Restricted and painful neck movements
- Feeling of tightness or muscle twitching
- Tenderness and deep, constant pain in affected area
Upon physical examination, poor posture such as slumped shoulders or decreased curve in the neck may be observed. There shouldn’t be any muscle thinning in the neck region. It’s common to find trigger points (hyper-irritable areas that cause pain when touched) in the painful area. A tight strip of muscle may be felt in the skeletal muscle or surrounding layer of tissue. Restrictions in neck movements may also be found. However, the neurological exam of the upper limbs, including strength, sensation, and reflexes, will appear normal.
Testing for Cervical Myofascial Pain
This condition is typically diagnosed by a doctor based on symptoms and a physical examination. There are no specific scans or tests that can confirm it. However, if the doctor suspects a serious neck-related medical condition, or if the symptoms don’t get better with treatment, they may use imaging tools like an MRI scan or an x-ray to investigate further.
Treatment Options for Cervical Myofascial Pain
There are several ways to manage cervical myofascial pain syndrome, which is chronic pain in the muscle and soft tissue around the neck. Treatments usually involve physical therapy, injections at pain trigger points, medication, physical modalities, and injections of botulism toxin (a type of poison).
Physical therapy employs exercises and other techniques to bring balance back to the affected muscles and nearby tissues. Therapists focus on specialized stretching and strengthening exercises for the affected muscles to rectify any posture or mechanical problems that might be causing or adding to the pain. They also use techniques such as myofascial release (a type of manual pressure), massage, ultrasound, and phonophoresis (which uses ultrasound to help topical medicines penetrate deeper into tissues). The aim of these techniques is to reduce pain and prevent further injury.
Prescribed medication could include anti-inflammatory drugs, certain types of antidepressants, and muscle relaxants. These drugs help when used alongside exercise or physical therapy, but are not typically effective by themselves. Botulism toxin type A works by inhibiting a neurotransmitter, which can help reduce muscle contractions and lower pain levels.
Another treatment option is trigger point injections or dry needling, which can be very effective for treating the places where pain is most intense. Trigger point injections require injecting a saline solution, a steroid, or a local anesthetic into the specific area of pain. Dry needling is similar but involves no medication being injected into the area- it is similar to acupuncture.
Osteopathic manipulation therapy, a treatment that involves moving muscles and joints, can also be an effective treatment strategy for this condition.
What else can Cervical Myofascial Pain be?
When a diagnosis is being determined, several conditions might show similar symptoms. These conditions include:
- Strained neck muscles
- Thoracic outlet syndrome (a group of disorders that occur when blood vessels or nerves between your collarbone and your first rib are compressed)
- Spondylosis (a broad term for age-related wear and tear of the spinal disks)
- Cervical disk disease (changes in your cervical spine resulting from a damaged or deteriorating disk)
- Radiculopathy (a condition due to a compressed nerve in the spine causing pain, numbness or a tingling sensation)
- Muscle spasms
- Fibromyalgia (a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues)
What to expect with Cervical Myofascial Pain
The future outlook for this syndrome greatly depends on various factors. Generally, with the right treatment, patients often experience good relief. However, there’s also a chance for symptoms to continue over a long period or to come back. This is why it’s crucial to pinpoint the root cause of the problem, so the right, targeted treatment can be given. It appears that starting treatments early leads to better results.
Preventing Cervical Myofascial Pain
Educating the patient is crucial when it comes to handling and treating this syndrome. Regular exercise, especially exercises that focus on maintaining a good sitting posture, is really important. Understanding and applying the right way to move and use your body in everyday life can greatly improve recovery. It’s also likely that the patient will need to do some exercises at home for ongoing benefits.
