In this week's episode of the Spine & Nerve Podcast, Drs. Nicolas Karvelas and Brian Joves discuss a very underappreciated component of the chronic pain picture- myofascial pain syndrome.

Myofascial pain is pain of the muscle and associated connective tissue. It typically presents as regional pain with associated tension, decreased range of motion, and presence of trigger points. This prevalent condition affects about 85% of patients in chronic pain clinics and will affect an estimated 85% of the general population at some point in their lives.

Persistent myofascial nociceptive input appears particularly effective at inducing central sensitization. Notably, a 2012 article in The Pain Practitioner suggests that active trigger points are associated with elevated levels of biochemicals that contribute to sensitization. Constant myofascial pain input can result in decreased activation threshold of excitatory CNS nociceptive neurons, apoptosis of inhibitory nociceptive neurons, and an abnormal stress response. Over time, this may lead to muscle disuse, weakness, and dysfunction.

Listen as the doctors explore the pathophysiology of myofascial pain and its connection to central and peripheral sensitization. For an in-depth explanation of peripheral and central sensitization, check out our recent episode on pain chronification (https://anchor.fm/spine/episodes/Back-to-basics-the-Chronification-of-Pain-eon8fq).

This podcast is for information and educational purposes only, it is not meant to be medical advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.

1. Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger

Point Manual. VI and VII Baltimore: Williams & Wilkins; 1999.

2. Shah et al. New Frontiers in the Pathophysiology of Myofascial Pain. The Pain Practitioner. 2012.