Myofascial pain syndrome is a long-term pain condition. It involves some muscles and the thin cover of tissue that holds muscles in place, called fascia. Pressure on these areas, called trigger points, causes pain.

Sometimes, the pain is felt in other parts of the body. This is called referred pain. The pain often is felt as shoulder pain, back pain, tension headaches and face pain.

This syndrome can happen after a muscle has been tensed over and over. Repeated motions used in jobs or hobbies can be the cause. So can stress-related muscle tension, poor posture and weak muscles. In some cases, the cause of myofascial pain is unknown.

Almost everyone has felt muscle tension pain. But the pain of myofascial pain syndrome doesn't go away. Treatment options include exercise, massage, physical therapy and shots in the trigger points. Pain medicines and finding ways to relax also can help.


Symptoms of myofascial pain syndrome may include:

  • Deep, aching pain in a muscle.
  • Pain that doesn't go away or gets worse.
  • A tender knot in a muscle.
  • Trouble sleeping due to pain.
  • A general feeling of being not well, called malaise.
  • Tiredness.

When to see a doctor

Most people have muscle pain at times. But if your muscle pain doesn't go away with rest, massage and other self-care measures, make an appointment with your healthcare professional.


The exact cause of myofascial pain syndrome is not known. Areas of tight muscle fibers, called trigger points, form in muscles. Too much use of the muscles, most often with poor form, injury to the muscle and mental stress likely help cause trigger points.

Risk factors

In myofascial pain syndrome, something such as muscle tightness sets off trigger points in the muscles. Factors that may increase the risk of muscle trigger points include:

  • Muscle injury. A muscle injury or ongoing muscle stress may lead to the forming of trigger points. For instance, a spot in or near a strained muscle may become a trigger point. Repeat motions and poor posture also can increase the risk.
  • Stress and anxiety. People who often feel stressed and anxious may be more likely to get trigger points in their muscles. One theory is that these people may be more likely to clench their muscles. Clenching is a form of repeated strain that leaves muscles open to trigger points.


Complications linked to myofascial pain syndrome include:

  • Sleep problems. Symptoms of myofascial pain syndrome may make it hard to sleep. It might be hard to find a good sleep position. And if you move while sleeping, you might hit a trigger point and awaken.
  • Fibromyalgia. Some research suggests that myofascial pain syndrome may lead to fibromyalgia in some people. Fibromyalgia is a long-term condition of widespread pain.

    It's believed that the brains of people with fibromyalgia respond more to pain signals over time. Some experts believe myofascial pain syndrome might help start this process.

Jan. 05, 2024
  1. Elsevier Point of Care. Clinical Overview. Myofascial pain syndrome. https://www.clinicalkey.com. Accessed Aug. 23, 2023.
  2. 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.
  3. 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.
  4. 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.
  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.
  6. 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.


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