Chronic Myofascial Pain (CMP) is a disease affecting the chemical responses between the nerve endings and the muscle fiber affected. CMP is a chronic disorder in which sensory, motor, and autonomic symptoms are caused by myofascial trigger points (TMP's). This condition may develop in muscles that are overstressed, overused, or injured.

CMP affects the fascia (connective tissue that covers the muscles), in which there is abnormal sustained contraction of part of a muscle. These muscle knots can form degenerated hard, painful nodules called Myofascial Trigger points (MTP's). Unfortunately, if left untreated, more MTP's can develop and spread to a wider area or extend to the other side of your body. This is called Recruitment.

Myofascial Trigger Points can cause severe debilitating pain in areas remote from the source. Trigger points are usually associated with a taut band, a ropey thickening of the muscle tissue. Typically a trigger point, when pressed upon, will cause the pain to be felt elsewhere. This is what is considered "referred pain". These pain referral patterns are very consistent, for example, pressure on a MTP in the low back can radiate to the lower buttock area. Pressing on the neck can be felt down the arm or up into the head.

Yes, CMP is Real

A report from a clinic specializing in head and neck pain reported chronic myofascial pain in 55% of their cases. Patients evaluated in one pain management center were found to have a myofascial component to their pain in 95% of cases¹. There is increasing awareness that active MTP's often play a role in the symptoms of patients with tension headaches, low back pain, neck pain, temporomandibular pain, forearm and hand pain, postural pain, pelvic/urogenital pain syndromes. CMP is characterized by pain and stiffness that is restricted to certain locations on the body. Like Fibromyalgia (FM), CMP is not a psychological disturbance, and neither condition is a mental illness, although chronic pain can cause anxiety and lead to depression. The American Medical Association, the World Health Organization, and the National Institutes of Health are among those who have accepted these as legitimate physical illnesses and major causes of disability².

Invisible Pain

Patients with CMP and/or FM have "invisible" chronic pain. Since patients usually appear to be healthy, others may not understand or even believe them when they say they hurt. Practitioners who do not believe these patients frequently don't realize how much patients with CMP or FM may suffer. Pain waxes and wanes, but it's always present, and at times the pain can be severe. Chronic pain can be exhausting and demoralizing³. Unlike Fibromyalgia, CMP effects men and women in the same numbers.

The Search Begins

It's not uncommon for patients to go from one doctor to another, undergoing numerous tests over a period of several years before a diagnosis of CMP or FM is finally made. These patients are frequently misunderstood and doubted by their doctors and family. They may even, at times, doubt themselves and feel guilty for not being able to "do their share". Once diagnosed, these patients often feel a profound sense of relief when they finally learn they have a recognized illness. Many patients are relieved to know they're not alone and that there are others who share the same symptoms and who understand the difficulty involved in obtaining appropriate medical care.

Don't give Up

It's important for healthcare providers to be aware that CMP and FM are real diseases. They should not be classified as "wastebaskets" into which patients who complain of pain but do not have other clear-cut diagnoses, should be "dumped." If you encounter any healthcare provider who does not believe in the validity of CMP and FM, then you should change to a better-educated healthcare professional! Our doctor database is a great place to begin looking. We have doctors in 78 countries worldwide that specialize in helping people with FM and/or CMP.

How CMP Works

Fascia surrounds, infuses and protects every other tissue, tendon, muscle, bone, ligament and organ of the body. In healthy conditions the fascia system is relaxed and wavy in configuration. This provides a cushioning and supportive mechanism allowing us to move safely without restriction or pain. Collagen and elastin, fascias two main components, allow it to be very strong yet have a high degree of flexibility. Fascia is also dynamic in nature, it responds to internal and external forces applied on it meeting the resistance in order to protect⁴.

Following all physical and emotional trauma and through poor posture, fascia scars and hardens in the affected site and along the tension lines imposed on it. This causes the fascia network to lose its cushioning mechanism and internal structures become pulled out of alignment. This in turn creates an abnormal pressure, up to 2,000 pounds per square inch, crushing nerves, blood and lymphatic vessels and further creating tension on adjacent pain-sensitive structures and those along the fascia pull.

When the fascia network is traumatized it is pulled and twisted out of alignment. Therefore, if the fascia has tightened creating bands of tension 3 dimensionally throughout the body resulting in symptoms distant to the injury then all the appropriate localized treatments will produce limited or temporary results. Facial restrictions do not show up on CAT scans, MRI's or X Rays therefore many patients are suffering unresolved physical and emotional pain due to undiagnosed fascia trauma.

Source(s):

1. Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surg Oral Med Oral Pathol 1985; 60(6):615-23.

2. Starlanyl D, Copeland ME. Fibromyalgia & Chronic Myofascial Pain, 2nd ed. Oakland CA: New Harbinger Publications, Inc; 2001.

3. Chino AF, Davis CD. Validate your pain! Exposing the chronic pain cover-up. Sanford, FL: InSync Communications LLC and Health Access Press; 2000 (http://www.validateyourpain.com).

4. John F Barnes. Myofascial Release Therapy in the UK, Do you Suffer from Chronic Myofascial Pain?. The Natural Therapy Centre (http://www.whtherapies.com/myofascial_release.htm).