근근막 통증증후군

Abstract

Myofascial pain syndrome (MPS) is a painful musculoskeletal condition produced by myofascial trigger points, which are locally tender when active, with the pain referred through specific patterns to other areas of the body. Myofascial trigger points produce specific regional pain complaints, and refer both tenderness and pain. The referred pain pattern is usually valuable in helping to in identifying the muscles responsible for the myofascial trigger points. Patients with myofascial trigger points usually present with persistent pain, tight or aching muscles, a limited range of motion and general fatigue, or a combination of these. The intensity of myofascial pain ranges from low level, felt as a mild ache, to an excruciating aching or burning pain, or both. Diagnosis of MPS requires a detailed history of the pain problem, the patient's personal and family history, a general physical examination and a systemic search for the myofascial trigger points. Patients complain that the regional aching pain, the onset of which is related to acute, chronic or repetitive muscle overload. The diagnostic findings of myofascial trigger points are painful limitation, a palpable taut band and jump sign. Treatment of myofascial pain syndromes revolves around the interruption of the pain cycle by eliminating the myofascial trigger points. This may be accomplished by penetrating the trigger point with a needle, injecting a local anesthetic, a weak steroid solution, or saline alone, or by spraying the skin overlying the muscle containing the trigger area with a vapocoolant. Elimination of the perpetuating factors permits spontaneous inactivation of the myofascial trigger points.