EpistemisSegmental myofascial pain
Specialty: Musculoskeletal.
Why it occurs
- Chronic muscle overload due to sustained work postures or postural vices
- Psychological stress and emotional tension (induces muscle spasm through the sympathetic pathway)
- Sleep disturbances with poor muscle repair
- Nutritional deficiencies of folate, vitamin B12 or vitamin D
- Underlying joint disorders that generate defensive muscle contractures
- Direct muscle trauma or poorly rehabilitated muscle microtears
Initial workup
The diagnosis is fundamentally clinical through palpation of tense muscle bands and reproduction of referred pain (Active Trigger Points) | General analysis including levels of vitamin D, thyroid hormones (TSH, free T4) and acute phase reactants.
red flags
Refractory muscle pain that does not improve with rest or physical measures, associated with sudden weight loss, fever of unknown origin, or hard regional lymphadenopathy (rule out muscle pain referred by oncological or deep infectious pathology).
Standard management
- Cyclobenzaprine — 5 mg orally every 8 or 12 hours for short periods of 7 to 10 days; muscle relaxant
- Amitriptyline — 10-25 mg orally at night, useful for modulating chronic pain and improving sleep quality
- Dry needling or local infiltration of the trigger point with 1% lidocaine (without vasoconstrictor).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Musculoskeletal
- Listed causes
- 6
- Treatment options
- 3