The muscles are always inexplicably sore, and they also have bone pain and stomach pain... Experts from the multidisciplinary collaborative pain science team of Beijing Union Medical College Hospital suggest that people may suffer from myofascial pain syndrome when they have these pain symptoms, and the cause is related to daily habits and actions such as sitting for a long time and crossing their legs.
Myofascial pain syndrome is a functional disorder of the muscle and fascia system. The patients mostly show repeated muscle acid swelling, pain and discomfort at the injury site, aggravating at rest, alleviating after appropriate activities, accompanied by local muscle stiffness and tension, and aggravating pain during pressing. In severe cases, local contracture and hard knot can be touched.
Cui Xulei, deputy chief physician of the Department of Anesthesiology of Beijing Union Medical College Hospital, said that the sites of pain caused by these compressions are the trigger points of fascial pain. Muscles in all parts of the body, including the neck, shoulder and waist, may have myofascial trigger points and cause myofascial pain syndromes in different parts.
It should be noted that if the trigger point is hidden, it is very easy to miss diagnosis and misdiagnosis.
Cui Xulei shared two cases. A woman suffered from dull pain in the right hip area and tailbone area for unknown reasons, which gradually worsened and even affected the back of her thigh. For this reason, she visited gynecology department, anorectal department, neurology department, orthopaedics department, pain department, etc. and received various treatments such as intervertebral disc radiofrequency and acupuncture, but the pain was not significantly relieved.
Another woman suffered from recurrent right lower abdominal pain for 3 years. Abdominal CT and gastrointestinal examination were performed in the local hospital, and no abnormalities were found. "Ovarian cyst resection" was performed in gynecology department, but the pain was not relieved after operation.
After detailed physical examination, it was found that the two women had obvious tenderness and cord nodules in pelvic floor muscle and psoas major muscle respectively. This is the trigger point of myofascial pain that caused the two women's pain.
Cui Xulei explained that many factors can directly or indirectly induce myofascial dysfunction and pain, such as trauma, habitual movements in work or life, chronic strain, pregnancy and trace element deficiency (vitamin D). Some office workers often sit for a long time and bend their legs to put them in front of their chest, so that the pelvic floor muscles are in a state of traction for a long time, which may be the potential reason for the formation of myofascial injury.
The main pathogenic mechanism of myofascial pain is energy crisis. When the muscle or muscle group is damaged for some reason, the muscle fiber is congested and edema, the local microenvironment changes, the inflammatory factors are released, the muscle fiber continues to contract and exhaust energy, and the metabolic balance is broken, which can cause muscle pain, stiffness, spasm, compression and irritation.
Cui Xulei suggested that when myofascial pain occurs, more attention should be paid to rest in the acute phase, and appropriate anti-inflammatory and analgesic drugs can be taken orally. In the recovery period of patients with mild illness, they can gradually resume activities and stretch exercises under the guidance of rehabilitation specialists. For patients with severe injury and significant impact of pain on daily life or work, they should actively go to the pain clinic for treatment to avoid the formation of chronic inflammation, which will lead to the delay of pain.
