Myofascial Pain Syndrome and Pseudoscatic Pain Symptoms

Myofascial Pain Syndrome & Pseudoscatic Pain

Hello, doctor.
I have some questions regarding my symptoms.
I have lumbar lordosis and a congenital fissure near the left sacrum at the L5 vertebra.
Currently, I often experience lower back pain, my legs easily become numb, and I feel pain on the outer side of my calves.
When I wake up after resting my arms on the table, my limbs are often numb.
After sitting for a long time, my calves sometimes feel numb, and at other times, they are quite painful.
Occasionally, when I get up, my feet have little to no sensation (though this is rare).
It seems that both of my legs experience numbness or pain simultaneously.
Could this possibly be myofascial pain syndrome or pseudoscatic pain? Thank you.

A-Wen, 20~29 year old female. Ask Date: 2004/08/04

Dr. Lai Lunxiang reply Neurology

I personally believe that what you mentioned is not accurate, and I think there are two other issues: 1.
Poor blood circulation (symptoms such as numbness in the hands and feet).
2.
The lower back pain may be related to prolonged sitting, but it has not reached the level of sciatica.
Increasing water intake, moving around more, avoiding prolonged standing or sitting, and ensuring adequate rest may be more helpful.

Reply Date: 2004/08/04

More Info

Myofascial Pain Syndrome (MPS) and Pseudoscatic Pain are two conditions that can cause significant discomfort and may share overlapping symptoms, making it challenging to differentiate between them. Based on your description, it seems you are experiencing a combination of symptoms that could indeed be related to either of these conditions, or possibly both.

Understanding Myofascial Pain Syndrome:
MPS is characterized by the presence of trigger points in the muscles, which are hyperirritable spots that can cause localized pain and referred pain in other areas. Patients often report a deep, aching pain that can be exacerbated by movement or pressure on the affected muscles. Common symptoms include:
1. Localized Pain: Pain is often felt in specific muscle groups, and pressing on these trigger points can elicit pain.

2. Referred Pain: Pain may radiate to other areas, which can sometimes mimic nerve pain.

3. Muscle Stiffness: Patients may experience stiffness and reduced range of motion in the affected muscles.

4. Fatigue: Chronic pain can lead to fatigue and a decrease in overall activity levels.

Understanding Pseudoscatic Pain:
Pseudoscatic pain, on the other hand, refers to symptoms that mimic sciatica but are not caused by nerve root compression. This can occur due to muscle tightness, particularly in the piriformis muscle, which can irritate the sciatic nerve. Symptoms may include:
1. Radiating Pain: Pain that travels down the leg, often mimicking true sciatica.

2. Numbness and Tingling: Patients may experience numbness or tingling sensations in the legs or feet.

3. Pain with Movement: Symptoms may worsen with certain movements or prolonged sitting.

Your Symptoms:
From your description, it appears you have a combination of symptoms that could align with both MPS and pseudoscatic pain. The presence of lumbar lordosis (exaggerated inward curvature of the lower back) and a congenital defect at the L5-S1 level could contribute to muscle imbalances and increased tension in the surrounding musculature, leading to:
- Lower Back Pain: This could be due to muscle strain or trigger points in the lumbar region.

- Leg Symptoms: The numbness and pain in your legs, particularly when sitting for extended periods or after sleeping, could suggest nerve irritation or compression, possibly related to muscle tightness in the lower back or gluteal region.

Next Steps:
1. Consult a Specialist: It would be beneficial to consult with a healthcare provider who specializes in musculoskeletal disorders, such as a physical therapist or a pain management specialist. They can perform a thorough assessment to determine the underlying causes of your symptoms.

2. Physical Therapy: Engaging in physical therapy can help address muscle imbalances, improve flexibility, and strengthen the core and lower back muscles. Techniques such as myofascial release, stretching, and strengthening exercises can be effective.

3. Pain Management: If your pain is significant, a pain management specialist may recommend treatments such as trigger point injections, medications, or other modalities to help alleviate your symptoms.

4. Lifestyle Modifications: Incorporating regular exercise, maintaining good posture, and avoiding prolonged sitting can help manage symptoms.

In summary, while your symptoms may suggest myofascial pain syndrome and pseudoscatic pain, a comprehensive evaluation by a healthcare professional is essential for an accurate diagnosis and effective treatment plan. Addressing these issues early can help prevent further complications and improve your quality of life.

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