Abstract
One of the most common chronic musculoskeletal pain syndromes is myofascial pain syndrome (MPS). Trigger points (TrPs) are hypersensitive taut bands that appear in two genres, each with a different ratio in specific areas of the muscles, and when triggered, they can produce pain, numbness, and tingling. Various underlying causes (mechanical, nutritional, and psychological) have been discovered to participate in the pathogenesis of MPS, activating trigger points and intensifying the pain. Furthermore, genetic, social, and psychological factors seem to exacerbate these patients' clinical appearance, according to the biopsychosocial model, which seems to be closely linked to the formation of trigger points. Chronic pain and psychological distress frequently coexist, and psychological and social factors have been found to worsen the patient's quality of life and perpetuate the existing pain. The diagnosis is formed following a comprehensive physical and clinical examination, and the appropriate management technique is selected. For MPS treatment, management techniques based on the biopsychosocial model are used in conjunction with various myofascial release strategies and pharmacologic care. Exercise, posture correction, and a vitamin balance in the diet, especially in the Vitamin B complex, appear to prevent trigger point (TrP) activation. The precise etiology of MPS is not clear yet, and further research is needed to determine the root cause. A holistic approach, which blends the basic clinical care with the management of the biopsychosocial model, is essential to patients with MPS to regain their function and improve their quality of life and wellbeing.
Highlights
The term and concept of pain have been defined by the International Association for the Study of Pain (IASP) as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage" [1]
Myofascial pain syndrome is considered a high prevalence among the population, and its multidimensional and complex nature demands a more holistic and personalized approach from the physicians to be treated
The biopsychosocial model is an interaction between biological, psychological, and social factors, which contribute both to the activation Trigger points (TrPs) and perpetuate myofascial pain
Summary
The term and concept of pain have been defined by the International Association for the Study of Pain (IASP) as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage" [1]. The mechanical and psychological stress of the muscle may activate the trigger points and cause pain over a large area. Because of this convergence and the fact that stimuli from the skin most often activate the spinal neurons, the pain in patients with MPS may radiate in a specific area of the skin [16] Mechanical factors such as poor posture and abnormal alignment of the joints (e.g., scoliosis, kyphosis, wry neck), which forces the musculoskeletal system to work in a compensatory way, and overuse syndromes seem to be the leading causes of activation of the trigger points [16]. Chronic pain can significantly reduce dopamine activity at a molecular level, a hormone associated with reward-motivated behavior and happiness [25,26] This mechanism occurs in the limbic midbrain area, 2021 Koukoulithras et al Cureus 13(4): e14737.
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