Sindromul dureros miofascial

Sindromul dureros miofascial este o boală de durere cronică care provoacă durerea în mai multe părți
ale corpului. Acest sindrom dureros apare de obicei când mușchiul s-a contractat în mod repetat.
Contracțiile repetate pot să apară din cauza mișcărilor repetitive folosite în anumite ocupații și hobby-uri
sau din cauza unei tensiuni musculare aferente unei situații stresante. Aproape orice persoană care a
experimentat durerea tensiunii mușchilor. Totuși, disconfortul pe care sindromul dureros miofascial îl
aduce este constant și se înrăutățește. Tratamentele pentru sindromul dureros miofascial sunt de obicei
terapiile fizice, injecțiile care declanșează punctele, cât și unele medicamente sau metode de relaxare
care pot ajuta la ameliorarea durerii.

Simptome

Simptomele sunt de obicei:

Durerea mușchilor

Durerea acută a mușchilor

Durerea constantă

Durerea se înrăutățește în timp

Probleme de somn din cauza durerii

O persoană ar trebui să viziteze doctorul când durerea este constantă și severă, chiar dacă se odihnește,
masează și ia alte măsuri de îngrijire.

Cauze

După rănirea sau folosirea excesivă a mușchilor, părțile sensibile din fibrele musculare pot fi formate în
mușchi. Aceste părți sensibile sunt denumite puncte de declanșare. Aceste puncte de declanșare pot
cauza dureri severe de mușchi. Boala numită sindrom dureros miofascial apare în momentul în care
durerea devine constantă și se înrăutățește.

Factori de risc

Durerea miofascială este cauzată de presiunea care pornește punctele de declanșare din mușchi. Factorii
care pot face ca riscul declanșării punctelor să fie mai mare sunt:

Rănirea mușchilor – tensionarea continuă a mușchilor sau rănirea profundă a mușchilor poate duce la
dezvoltarea punctelor de declanșare

Mișcarea repetitivă la efectuarea unei anumite ocupații

Postura greșită
Stresul

Anxietatea

Complicații

Complicațiile care pot să apară din sindromul dureros miofascial pot fi:

Probleme de somn – probleme în a găsit poziția confortabilă din cauza durerii și a posibilității a declanșa
un punct.

Fibromialgia – boala cronică care face ca durerea să se extindă în corp.

Tratament

Tratamentele pentru sindromul dureros miofascial pot fi medicamentele, injecțiile sau terapia fizică.

Medicamentele: analgezice, antidepresive și sedative

Terapia fizică: masaj, întindere, exerciții de întărirea mușchilor, îmbunătățirea posturii, aplicarea de
căldură și ultrasunete.

Injectarea punctului de declanșare

Următoarele metode de auto îngrijire pot ajuta în ameliorarea durerii, cât și în păstrarea corpului
sănătos:

Exerciții ușoare și mișcare în momentul în care durerea nu este mare

Relaxarea și meditarea pentru a reduce tensiunea și stresul

Dieta sănătoasă care include multe fructe și legume

Suficient somn și odihnă.

Myofascial pain syndrome

Overview

Myofascial pain syndrome is a chronic pain disorder. In this condition, pressure on sensitive points in
your muscles (trigger points) causes pain in the muscle and sometimes in seemingly unrelated parts of
your body. This is called referred pain.

This syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by
repetitive motions used in jobs or hobbies or by stress-related muscle tension.

While nearly everyone has experienced muscle tension pain, the discomfort associated with myofascial
pain syndrome persists or worsens. Treatment options include physical therapy and trigger point
injections. Pain medications and relaxation techniques also can help.

Products & Services

 Newsletter: Mayo Clinic Health Letter

Symptoms

Signs and symptoms of myofascial pain syndrome may include:

 Deep, aching pain in a muscle

 Pain that persists or worsens

 A tender knot in a muscle

 Difficulty sleeping due to pain

When to see a doctor

Make an appointment with your doctor if you experience muscle pain that doesn't go away. Nearly
everyone experiences muscle pain from time to time. But if your muscle pain persists despite rest,
massage and similar self-care measures, make an appointment with your doctor.

Causes

Sensitive areas of tight muscle fibers can form in your muscles after injuries or overuse. These sensitive
areas are called trigger points. A trigger point in a muscle can cause strain and pain throughout the
muscle. When this pain persists and worsens, doctors call it myofascial pain syndrome.

Risk factors

Myofascial pain syndrome is caused by a stimulus, such as muscle tightness, that sets off trigger points
in your muscles. Factors that may increase your risk of muscle trigger points include:

 Muscle injury. An acute muscle injury or continual muscle stress may lead to the development
of trigger points. For example, a spot within or near a strained muscle may become a trigger
point. Repetitive motions and poor posture also may increase your risk.
  Stress and anxiety. People who frequently experience stress and anxiety may be more likely to
develop trigger points in their muscles. One theory holds that these people may be more likely
to clench their muscles, a form of repeated strain that leaves muscles susceptible to trigger
points.

Complications

Complications associated with myofascial pain syndrome may include:

 Sleep problems. Signs and symptoms of myofascial pain syndrome may make it difficult to sleep
at night. You may have trouble finding a comfortable sleep position. And if you move at night,
you might hit a trigger point and awaken.

 Fibromyalgia. Some research suggests that myofascial pain syndrome may develop into
fibromyalgia in some people. Fibromyalgia is a chronic condition that features widespread pain.
It's believed that the brains of people with fibromyalgia become more sensitive to pain signals
over time. Some doctors believe myofascial pain syndrome may play a role in starting this
process.

Diagnosis

During the physical exam, your doctor may apply gentle finger pressure to the painful area, feeling for
tense areas. Certain ways of pressing on the trigger point can elicit specific responses. For instance, you
may experience a muscle twitch.

Muscle pain has many possible causes. Your doctor may recommend other tests and procedures to rule
out other causes of muscle pain.

Treatment

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

Medications

Medications used for myofascial pain syndrome include:

 Pain relievers. Over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB, others) and
naproxen sodium (Aleve) may help some people. Or your doctor may prescribe stronger pain
relievers. Some are available in patches that you place on your skin.

 Antidepressants. Many types of antidepressants can help relieve pain. For some people with
myofascial pain syndrome, amitriptyline appears to reduce pain and improve sleep.

 Sedatives. Clonazepam (Klonopin) helps treat the anxiety and poor sleep that sometimes occur
with myofascial pain syndrome. It must be used carefully because it can cause sleepiness and
can be habit-forming.
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.

 Posture training. Improving your posture can help relieve myofascial pain, particularly in your
neck. Exercises that strengthen the muscles surrounding your trigger point will help you avoid
overworking any one muscle.

 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.

 Heat. Applying heat, via a hot pack or a hot shower, can help relieve muscle tension and reduce
pain.

 Ultrasound. This type of therapy uses sound waves to increase blood circulation and warmth,
which may promote healing in muscles affected by myofascial pain syndrome.

Needle procedures

Injecting a numbing agent or a steroid into a trigger point can help relieve pain. In some people, just the
act of inserting the needle into the trigger point helps break up the muscle tension. Called dry needling,
this technique involves inserting a needle into several places in and around the trigger point.
Acupuncture also appears to be helpful for some people who have myofascial pain syndrome

about MFR

Myofascial Release (MFR) is a specialised physical and manual therapy used for the effective treatment
and rehabilitation of soft tissue and fascial aches, pains, tension and restrictions.

It is traditionally accepted that myofascia is the connective tissue (fascia) in and around muscles, where
muscles are the powerhouses of locomotion and posture for the body. Myofascial release is, therefore,
an application used to alleviate tension, restrictions and adhesions in the myofascia in order to restore
balance and function. Muscles respond well to firm deep pressure which is probably why MFR
specifically targeting muscles and kinetic chains (muscle chains) uses a relatively firm force applied by
the practitioner and also why therapy tools such as foam rollers, cricket balls and sports peanuts are so
popular. Many people, especially sports people, like firm pressure and feel that muscular stretch and
deep therapy work benefits them. When people are fit, healthy and physically active, deeper MFR
approaches can be appropriate but never to the painful stage. However, consideration has to be taken
in to account that excessive and aggressive deep work either by an unskilled practitioner or by the use of
therapy tools by an uneducated person could actually create more restriction, scarring and
inflammation and therefore damage tissue. Using firm pressure may affect the deep muscular tissue but
can have a damaging affect on the more fragile superficial tissues.

The general understanding of ‘myofascial release’ has changed over the last decade since MFR UK has
been providing workshops for healthcare professionals. In the past, MFR was a treatment approach in
its own right and everything else was called massage. However, with popularity comes ambiguity and
what MFR is and how it’s applied has become somewhat lost in translation over recent years. Normally
the term ‘massage’ describes a fluid movement over the body using lubrication. As the popularity of
MFR grows, massage treatments are being renamed ‘MFR’ to keep up with the current trends creating
confusion for both practitioners seeking professional MFR training and for clients seeking resolve from
their pain and discomfort. The thought is that as massage treats muscles, then myofascia must be being
treated as well. This is not strictly incorrect as you can’t influence one without influencing the other.
This is also why self-care approaches such as foam rolling have become termed ‘self-myofascial release’,
or SMFR, yet a practitioner using their forearm on your leg in a massage is the same application of
stroke but can still be called massage or soft tissue therapy.

Confusingly, the term massage and MFR seem to have become interchangeable. However, it is of huge
value to understand that not all fascia is myofascia and true MFR treats the entire fascial structures
not only that of the muscular system.

No-one owns the term ‘myofascial release’ and it is indeed only a term just like the term massage.
However, as research into fascia has increased, the awareness of what fascia is has cultivated a change
of thinking as to what tissues we are actually treating when we touch the human body. Can you really
touch the skin without influencing the tissues below? Can we really affect muscle without influencing
the skin and the superficial fascia above and can we actually affect the visceral tissues when the muscles
above are restricted? In addition, if all fascial structures are lubricated by the viscous ground substance
(gel fascia), which is a non-Newtonian fluid resisting pressure in order to protect, then fascial
applications should be applied to influence more than the myofascia alone. When the fascial system is
restricted, the ground substance becomes thicker (more viscous). This means less lubrication for the soft
tissue and myofascial structures meaning they adhered together creating internal scarring and
dysfunction affecting all other structures. The fascial is a totally connected system and is the system that
touches all others.Which then brings the next consideration. if the fascial system touches all other
systems, then by default, all therapeutic applications which physically influence the body, have to be
fascial. However, before we get carried away, it’s not what we do, it’s how we do it that makes the
difference.

Traditional MFR approaches, and certainly, those massage approaches renamed MFR, fail to address the
entire 3D fascial system but maintain a myopic point of view providing short lived results for many
people.

Moreover, some MFR approaches have been shown to be too aggressive for chronic and persistent
pain sufferers and even make their conditions worse.
As research has progressed, we have learned so much more about the fascial system where a firm, deep
pressure into the system has been replaced by a cultivated kinesthetic and skilled touch refined by
knowledge of mechanotransduction, fluid dynamics, piezoelectricity and viscosity. The days of ‘no pain,
no gain’ are gone and is replaced by ‘pain, no gain’

The next issue we have is the term ‘myofascial release’ isn’t quite accurate either. New research has
highlighted that we can’t actually ‘release’ anything with exception of releasing perceived tension. Yet,
MFR is the recognised term and is probably the term that will stay in the manual therapy toolbox.

MFR does not use oils or lotions, it is performed dry so that the practitioner avoids glide over the skin
but can feel deeper into the tissue. MFR UK cultivates a sense of touch so that each and every treatment
is uniquely delivered with skilled ‘listening’ hands. Regardless of your client base being derived from the
sports, athletic and performance field or whether you work with chronic and persistent pain, our
training provides a wealth of theory, research and effective techniques and MFR approaches to suit your
client base.

MFR UK teaches and promotes an integrated approach to MFR. We specialise in the sustained approach
to MFR where we are targeting the fluid ground substance of the fascial system following the ebb and
flow of the tissues in totality. These sustained techniques offer body wide change and tissue
reorganisation as well as offer a platform for emotional release and trauma resolve. Our integrated
approach teaches the practitioner the skill of feeling different layers and structures under their hands,
this is the art of kinesthetic touch. This approach allows practitioners to learn which techniques are
appropriate for individual clients and how to apply them in a bespoke manner. No one technique fits all,
instead, the skill of learning MFR is how much pressure to use and for how long to encourage tissue
change without force.