What Is the Cause of Myofascial Pain Syndrome?

Myofascial pain syndrome is a chronic condition that affects the connective tissue, which covers the muscles. With myofascial pain, pressure on sensitive trigger points in the muscle causes referred pain, which is a pain in a seemingly unrelated part of the body.

Dr. Hersel’s epidural injections have allowed me to get back to horseback riding.


Causes & Risk Factors

Myofascial pain syndrome is caused by a stimulus, such as pressure, that sets off trigger points in the muscles. Risk factors include muscle injury, stress and anxiety, and excessive strain on a particular muscle or muscle group. Other causes can include:

    • Injury to an intervertebral disc
    • General fatigue
    • Repetitive muscle motion
    • Medical conditions
    • Lack of activity


    • Deep, aching pain in a muscle
    • Trigger points that are tender to the touch
    • Pain that persists or worsens
    • A tender knot in the muscle
    • Difficulty sleeping due to pain


During a physical exam, your PMIR pain specialist may apply gentle pressure to the painful area in an attempt to elicit a response from its trigger points. In myofascial pain, four types of trigger points can be distinguished:

    • An active trigger point, which is an area of extreme tenderness that lies within the skeletal muscle.
    • A latent trigger point is a dormant area that has the potential to act as a trigger point.
    • A secondary trigger point is a susceptible spot in a muscle that can become active due to a trigger point and overload in another muscle.
    • A satellite myofascial trigger point is a susceptible spot in a muscle that becomes inactive because it is in the region of another trigger point.

Treatment Options

When treating myofascial pain, it is important to address factors that might be contributing to the condition, including poor posture, workplace ergonomics, or mechanical problems. The treatment options we offer for myofascial pain typically include:


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