Myofascial pain
I would like to ask if the pain phase of acute myofascial inflammation lasts a long time? I have never experienced shoulder pain before! It only started after I was too tense during acupuncture last time, and my prone position was incorrect, which caused me to exert myself improperly! Two days later, my shoulder became inflamed! It continued to hurt for a while, but after I received an injection at the pain point, I felt much better the next day! After resting for three weeks, I noticed that pressing on my shoulder no longer hurt! However, since my right scapula also started to hurt, I received another injection at the pain point! It has been three days since then, and I feel much better.
Is the relief from the injection due to the medication's effect? Is myofascial inflammation permanent? I am worried that it might be just the effect of the medication...
If pressing on the muscle no longer causes pain, does that mean the inflammation has resolved? Is this condition likely to recur?
Yang Er, 10~19 year old female. Ask Date: 2004/09/11
Dr. Xu Zhenrong reply Rehabilitation
Hello, Yang Er: The issues with your shoulders may be due to poor posture and muscle stiffness caused by stress, along with improper exertion leading to muscle or tendon strains.
The clinical treatment approach is summarized as follows:
1.
Acute Phase: Within 24-48 hours post-injury, oral non-steroidal anti-inflammatory drugs (NSAIDs), ice application, and rest for the injured area can help reduce swelling and pain.
2.
Chronic Phase: After 24-48 hours post-injury, if there are no symptoms of redness, swelling, or heat, local heat application and physical therapy modalities such as electrical stimulation can be utilized to relax the tissues and alleviate pain.
This should be complemented with therapeutic exercises to restore the original flexibility and strength of the injured tissues.
NSAIDs can still be taken during this phase.
If pain persists and does not improve effectively, a physician may consider local corticosteroid injections for rapid anti-inflammatory and analgesic effects; however, multiple injections in the same area should be avoided to protect tissue extensibility.
Currently, if you have no pain or tenderness and your limb movement is not restricted, it indicates complete recovery.
However, it is essential to maintain good posture and engage in sufficient exercise to prevent re-injury, as previously injured tissues are generally more vulnerable and require extra care.
Thank you for your inquiry, and I hope this information is helpful to you!
Dr.
Hsu Chen-Jung, Director of Rehabilitation Department, Taipei Hospital
Reply Date: 2004/09/11
More Info
Myofascial pain syndrome (MPS) is a common condition characterized by the presence of trigger points—hyperirritable spots in skeletal muscle that can cause pain and discomfort. Understanding the duration, treatment options, and recovery insights for MPS is crucial for effective management.
Duration of Myofascial Pain
The duration of acute myofascial pain can vary significantly from person to person. In many cases, acute episodes can last from a few days to several weeks, depending on factors such as the severity of the trigger points, the individual’s overall health, and the effectiveness of the treatment methods employed. In your case, it seems that the pain developed after a specific incident related to posture and tension during acupuncture. This suggests that the pain may be linked to muscle strain or overuse, which can lead to inflammation and discomfort.
Treatment Options
1. Trigger Point Injections: As you have experienced, trigger point injections can provide significant relief. These injections typically contain a local anesthetic, such as lidocaine, and sometimes corticosteroids. The immediate reduction in pain you felt after the injection is likely due to the anesthetic effect, which can temporarily alleviate pain by blocking nerve signals in the area.
2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can guide you through specific stretching and strengthening exercises tailored to your condition. This can help improve muscle function, reduce tension, and prevent future episodes of pain.
3. Acupuncture: While you mentioned that acupuncture initially caused discomfort, it can also be a useful treatment for myofascial pain when performed correctly. It may help in reducing muscle tension and promoting blood flow to the affected areas.
4. Heat and Cold Therapy: Applying heat can help relax tight muscles, while cold therapy can reduce inflammation. Alternating between the two may provide additional relief.
5. Medications: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), can help manage pain and inflammation. However, it’s essential to consult with a healthcare provider before starting any medication regimen.
Recovery Insights
Regarding your concerns about whether the absence of pain upon pressing the muscle indicates that the inflammation has resolved, it is a positive sign. If you can apply pressure without discomfort, it suggests that the muscle may have healed sufficiently. However, it is essential to monitor your symptoms closely. Myofascial pain can be recurrent, especially if the underlying causes (such as poor posture or muscle imbalances) are not addressed.
Long-term Management
Myofascial pain syndrome can indeed be chronic and may recur if not managed appropriately. To minimize the risk of future flare-ups, consider the following:
- Posture Awareness: Being mindful of your posture during activities, especially when sitting or using electronic devices, can help prevent strain on your muscles.
- Regular Exercise: Engaging in regular physical activity can strengthen the muscles and improve flexibility, reducing the likelihood of developing trigger points.
- Stress Management: Since stress can contribute to muscle tension, incorporating relaxation techniques such as yoga or meditation may be beneficial.
Conclusion
In summary, while acute myofascial pain can be distressing, it is often manageable with appropriate treatment and lifestyle modifications. The relief you experienced from trigger point injections is a common response, and the absence of pain upon pressure suggests improvement. However, ongoing attention to posture, physical therapy, and stress management will be crucial in preventing recurrence. If symptoms persist or worsen, it is advisable to consult with a healthcare professional for further evaluation and tailored treatment options.
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