Myofascial Pain Treatment

Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director

Myofascial pain and the trigger points behind it

Myofascial pain syndrome is a chronic pain condition caused by trigger points — tight, hypersensitive knots within muscle fibers[1] that can cause local pain and referred pain to other areas of the body. Unlike general muscle soreness, myofascial trigger points persist and can cause a predictable pattern of referred pain. For example, trigger points in the upper trapezius muscle can cause headaches, while trigger points in the gluteal muscles can mimic sciatica. At IPC, we diagnose myofascial pain through careful palpation and clinical assessment, then treat it with targeted trigger point injections that deliver local anesthetic and sometimes corticosteroid directly into the trigger point to release the muscle contraction and break the pain cycle.

Symptoms of myofascial pain

Myofascial pain comes from muscle and the connective tissue surrounding it, and its defining feature is the trigger point — a discrete tender spot within a tight band of muscle that refers pain elsewhere when pressed.

• A deep, aching pain in a region of muscle rather than a joint, commonly across the neck, shoulders, upper back or low back
• A specific tender knot that, when pressed, reproduces pain in a different location — a shoulder trigger point causing headache, for instance
• A palpable taut band running through the muscle
• Persistent muscle tightness that stretching relieves only briefly
• Reduced flexibility, and pain that worsens with sustained posture, stress, poor sleep or cold

The referral pattern is the most useful clue, and it is the reason myofascial pain is often treated in the wrong place: the spot that hurts is frequently not the spot generating it.

When to see a pain specialist about myofascial pain

Consider an evaluation when muscle pain has persisted beyond several weeks despite stretching, heat, massage and over-the-counter medication, when it keeps returning to the same region, or when it is disturbing sleep.

Trigger point injections treat the taut band directly and are usually a brief office procedure. Where the pain is regional rather than focal, other targeted blocks may be more appropriate, and your physician will determine which fits your pattern. Persistent myofascial pain is also worth assessing because it commonly sits on top of another problem — an arthritic joint, a disc, or an old injury that changed how you move — and treating the muscle alone tends to give temporary relief in that situation.

Treatment options for myofascial pain

Both options below treat trigger points directly, and both work cumulatively rather than in a single session. They are normally combined with stretching and physical therapy rather than used on their own.

References

Clinical sources for this page.

1. Myofascial Pain Syndrome. StatPearls [Internet], National Library of Medicine; updated April 13, 2025. Back to first citation ↑