The first signs of the myofascial syndrome of any localization are pains of varying intensity, amplified by the strain of the affected muscle or pressure on the trigger point. In which place to expect pain depends on the location of the trigger points, as well as the size of the affected muscle. Because the pain is not always localized, the reflected pain can be felt along the entire length of this muscle.
Myofascial pain syndrome (MFES), depending on the location of the muscle with motor dysfunction can be divided into several types. In this case, localized and reflected pain, depending on the type of MSF, may be accompanied by other unpleasant symptoms.
Head and face
Myofascial pain syndrome in the face is a pathology with a rather wide symptomatology. In addition to dull, diffuse pain, it is characterized by multiple symptoms that cause patients to contact different doctors: lor, neurologist, dentist.
Patients can complain about difficulties with opening the mouth, clicking in the temporomandibular joint, rapid fatigue of the muscles when chewing food, pain when swallowing. The pain itself can spread to the area of the gums, teeth, pharynx, palate, ears.
Less often, in the diagnosis of myofascial syndrome, patients complain of symptoms such as more frequent blinking, nervous tics in different parts of the face, stuffiness of one or both ears, occasionally accompanied by noise or ringing in them.
Sometimes there is also an increased sensitivity of the teeth. It is this problem that is known for myofascial syndrome in dentistry. However, the rest of the symptomatology does not just talk about the neurological nature of the pathology, but also that the main reason is still in the muscle dysfunction.
With this pathology, trigger points can be found in the area of masticatory muscles, pterygoal processes of the sphenoid bone on both sides of the nose, in the temporomandibular joint region, and also in the upper part of the trapezius muscle (radiating pain in the temporal region).
Neck and shoulders
Cervical myofascial syndrome also begins with pains that can be localized either in the neck or occiput, or spread to the areas of the head, face, and forearms. In the next stage they are joined by vegetovascular disorders: dizziness, visual and hearing impairments, ringing in the ears, fainting. Could also appear "causeless" runny nose and intensify salivation.
In spite of the fact that in most cases trigger points with cervical myofascial syndrome are located mainly along the cervical spine and upper part of the shoulder girdle, single stress centers can also be found in the region:
- oblique and belt muscles of the head (burning pain in the nape and eyes, vegetative disorders),
- the middle section of the sternocleidomastoid muscle (pain on one side of the face, accompanied by lacrimation, increased salivation, rhinitis),
- in the zone of scapula or clavicle,
- upper sections of the trapezius muscle (pulsating pain in the temples),
- thoracic and subclavian muscles.
About half of patients with this pathology suffer from various sleep disorders, psychoemotional disorders, and a decrease in work capacity. About 30% developed panic attacks.
The appearance of severe pain in the chest area is most often associated with heart disease, and in particular with myocardial infarction. However, diagnostic studies do not always confirm this. The cause of pain in the chest can be the formation of seals in the muscles of the front of the chest, and then we are talking about a kind of myofascial breast syndrome called the anterior chest wall syndrome. It is characterized by dull aching pains more often on the left side of the sternum, which increase with bends of the trunk, lifting weights, dilating hands to the sides, coughing.
Despite the fact that with such a localization of trigger points, the symptomatology is mainly limited only by pains in the chest, the appearance of painful foci may be the result of some diseases of the chest cavity organs or even the back, which in itself is an occasion to undergo examination in a medical institution.
Another type of thoracic myofascial syndrome is the syndrome of the small pectoral muscle with localization of trigger points in its thickness. It is characterized by pain in the subclavian area, which can be irradiated to the shoulder or left arm. The pains are often accompanied by the appearance of goosebumps and the temporary loss of sensitivity of the limb.
Myofascial syndrome in the muscles of the back develops against the background of the appearance of painful nodules in the muscle, which runs along the thoracic spine, in the broadest muscle, in the rhomboid and subacute muscles. The place of pain localization in this case is the area between or under the shoulder blades, as well as over the shoulders.
The pain in this case is acute and occur suddenly, especially with overstrain or hypothermia of the muscles.
Myofascial syndrome of the lumbar region is characterized by pain in the lower region of the back, which can spread to the groin or sciatic nerve. The cause of back pain can be and disc hernias, and ostiomyelitis, and diseases of the digestive system, and even cancer that has released its metastases in this area. But most often it all comes down to overstrain of the muscles with a lot of physical exertion (for example, lifting weights) or to the displacement of the vertebrae in the lumbar spine.
If the time is not taken to cure the main diseases, trigger points are formed in the lumbar region, which provokes a painful pain syndrome.
Pelvic region and thigh
Symptoms of myofascial pelvic syndrome are more like symptoms of pathologies of the intestine or urogenital area. Sometimes complaints are reduced to the fact that the patient begins to feel as if he has a foreign body in his intestine. There are painful sensations when walking or when a person does not change the sitting position of the body for a long time. Localization of unpleasant sensations is predominantly the area of the lower back or lower abdomen.
Many patients report frequent urination. Women can also indicate discomfort in the internal genital area and anus.
All this symptomatology makes people turn to a gynecologist, urologist, andrologist who put the appropriate diagnoses: cystitis, prostatitis, urethritis, andeksit, etc. Long-term examinations and treatment according to the above diagnoses remain unsuccessful, while doctors can not find out the true cause of discomfort and pain in the pelvic area.
And everything turns out to be much simpler, and pains in the pelvic region provokes a spasm of muscles that hold such organs as the bladder, rectum, uterus and women, etc., in the small pelvis. Depending on which muscle is affected (m.piriformis, m.levator ani, m.obturatorius int, or superficial muscles), the pain may be localized in different parts of the pelvis and delivered to the hip.
Thus, in the pear-shaped muscle syndrome, pain in the buttocks and hamstrings is accompanied by discomfort during walking and having sex, pain during defecation and unpleasant aching pains in the rectum and perineum, arising at the slightest strain of perineal muscles.
The syndrome of the internal obturator muscle and muscle in the anus, sometimes called myofascial urethral syndrome, is characterized by pain in the vagina, anus or urethra, frequent painful urination, difficulties in defecation, discomfort in the lower abdomen, especially during sitting.
Myofascial syndrome in children
Strong muscular pains in childhood seem to be something out of the ordinary, however, this problem is much more urgent than it may seem at first glance. Yes, chronic pathologies in children with myofascial syndrome are unlikely to be detected. But in this case, the emphasis is not on them, but on the birth trauma of the spine and in particular of the cervical spine.
Slightly less than a third of children born have spinal and spinal injuries associated with the period of the child's appearance in the world, i.е. Passage of the fetus through the birth canal. More than 85% of these children receive various injuries to the cervical spine. About 70% of infants with various injuries of the spine are diagnosed with myofascial syndrome.
In older children and adolescents, myofascial pains occur most often either as a result of hypothermia of the muscles, followed by their spasms and the formation of trigger points, or as a result of incorrect posture (scoliosis and other similar pathologies). Often, muscular pains provoke children's inherent mobility and inadequate care for their health. As a result, we have pain syndrome associated with neck, spine and hip injuries or muscle overcooling, when a child after active games with intense perspiration is for some time in a draft or in a poorly heated room.
Cervical myofascial syndrome in children is most often manifested by headaches, pain in the eyes, dizziness, loss of balance. Damages of the shoulder girdle and spine are manifested by pains in the back and upper limbs, and injuries of the hip and knee joint - pain under the knee, in the shin area, in the anterior and outer thigh area, in the groin.