Print DiagnosisDuring a physical exam, your healthcare professional may put gentle finger pressure on the affected muscle, feeling for painful areas. Certain ways of pressing on the trigger point can cause certain responses. For instance, you might have a muscle twitch. Muscle pain has many possible causes. Your healthcare professional uses other tests and procedures to rule out other causes of muscle pain. TreatmentTreatment for myofascial pain syndrome typically includes medicines, shots into the trigger points and physical therapy. Exercise is a big part of any treatment plan. Discuss treatment options and what you prefer with your healthcare professional. You may need to try more than one approach to find pain relief. MedicationsMedicines used for myofascial pain syndrome include: Pain relievers. Pain relievers you can get without a prescription, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), may help. Some come in the form of creams or patches that you put on the skin. Or your healthcare professional may prescribe stronger pain relievers. Antidepressants. Many types of antidepressants can help relieve pain. For some people with myofascial pain syndrome, amitriptyline seems to reduce pain and improve sleep. Muscle relaxers. Clonazepam (Klonopin) and other medicines called benzodiazepines help treat the anxiety and poor sleep that sometimes come with myofascial pain syndrome. These medicines can cause sleepiness and can be habit-forming. TherapyA physical therapist can help relieve your pain based on your symptoms. Treatment might involve: Stretching. A physical therapist may lead you through gentle stretches to help ease the pain in your sore muscle. If you feel trigger point pain when stretching, the therapist may put a numbing spray on your skin. Massage. A physical therapist may massage your affected muscle to help relieve your pain. The therapist may use long hand strokes along your muscle or place pressure on areas of your muscle to release tension. Procedures Shots, also called injections, into trigger points. A shot of a numbing medicine or a steroid into a trigger point can help relieve pain. OnabotulinumtoxinA (Botox) also might be used. Dry needling. In some people, just putting the needle into the trigger point helps break up the muscle tension. This is called dry needling. Acupuncture also appears to help some people who have myofascial pain syndrome. Transcutaneous electronic nerve stimulation (TENS). This sends a tiny electrical current to painful areas. The current is sent using electrodes taped to the skin. It's not known how TENS relieves the pain. More study is needed. Ultrasound. This type of therapy uses sound waves to increase blood flow and warmth. This may reduce pain in the muscles affected by myofascial pain syndrome. Extracorporeal shock wave therapy. Sound waves are directed at the area of pain. Some studies have shown it to ease pain in myofascial pain syndrome. More InformationCortisone shots Request an appointment Coping and supportHaving a long-term pain condition such as myofascial pain syndrome can be upsetting. It may help to talk to a counselor about what you're facing. Online or in-person support groups also can be helpful. They can link you to people who know what you're going through. Preparing for your appointmentThe symptoms of myofascial pain syndrome are like those of other disorders. So you may see more than one healthcare professional before getting a diagnosis. What you can doYou're likely to start with a visit to your primary healthcare professional. You might then be sent to a specialist in muscle and joint conditions, called a rheumatologist. Here are some things you can do to get ready for your appointment. Make a list of: Your symptoms and when they began. Your key medical information. Include other conditions you have. List all medicines, vitamins or supplements you take, including doses. Questions to ask your healthcare professional. For myofascial pain syndrome, some basic questions to ask include: What might be causing my symptoms? Is my condition likely to go away on its own? Do I need treatment? What treatments are there? Do you have brochures or other printed material that I can have? What to expect from your doctorYour healthcare professional is likely to ask you questions, such as: Where do you feel the most pain? Do your symptoms o come and go, or do you always have them? Does anything seem to make your symptoms better? Does anything seem to make your symptoms worse? Are your symptoms worse in the morning or at any other time of the day? Do you use repeated motions on the job or for hobbies? Have you been injured recently? How does your pain limit what you can do? By Mayo Clinic Staff Request an appointment Symptoms & causesDoctors & departments Jan. 05, 2024 Print Show references Elsevier Point of Care. Clinical Overview. Myofascial pain syndrome. https://www.clinicalkey.com. Accessed Aug. 23, 2023. Barbero M, et al. Myofascial pain syndrome and trigger points: Evaluation and treatment in patients with musculoskeletal pain. Current Opinion in Supportive and Palliative Care. 2019; doi:10.1097/SPC.0000000000000445. Marcdante KJ, et al, eds. Musculoskeletal pain syndromes. In: Nelson Essentials of Pediatrics. 9th ed. Elsevier; 2023. http://www.clinicalkey.com. Accessed Aug. 23, 2023. Galasso A, et al. A comprehensive review of the treatment and management of myofascial pain syndrome. Current Pain and Headache Reports. 2020; doi:10.1007/s11916-020-00877-5. 10 ways to reduce pain. National Health Services. https://www.nhs.uk/live-well/pain/10-ways-to-ease-pain/. Accessed Aug. 24, 2023. He P, et al. The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: A systematic review. BMC Musculoskeletal Disorders. 2023; doi:10.1186/s12891-023-06418-6. Related Associated Procedures Cortisone shots Products & Services A Book: Mayo Clinic Family Health Book, 5th Edition Newsletter: Mayo Clinic Health Letter — Digital Edition Show more products and services from Mayo Clinic Myofascial pain syndromeSymptoms&causesDiagnosis&treatmentDoctors&departments Advertisement Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Advertising & Sponsorship Policy Opportunities Ad Choices Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. 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