The following are questions and answers regarding Chronic Myofascial Pain (CMP). Contact us if you have a question you'd like answered. Select from the table below for more FAQ's.

• What is CMP
• What Causes CMP
• Who Gets CMP
• How is CMP Diagnosed
• What Are The Symptoms of CFS
• How Is CMP Treated
• Does Stress Make CMP Worse
• Can CMP Be Cured
• Is CMP Contagious
• How Long Can CMP Last
• Can CMP be Prevented
• Is CMP Genetic
• What is a Trigger Point

ANSWER: Chronic Myofascial Pain (CMP) is a disease that 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.

ANSWER: Myofascial pain may develop from a muscle injury or from excessive strain on a particular muscle or muscle group, ligament or tendon. Other causes include:

• Sudden trauma to musculoskeletal tissues (muscles, ligaments, tendons, bursae)
• Injury to intervertebral disc
• General fatigue
• Nervous tension or stress
• Hormonal changes (eg, trigger point development during PMS or menopause)
• Repetitive motions; Excessive exercise; Muscle strain due to over activity
• Medical conditions (eg, gall bladder inflammation, heart attack, appendicitis, stomach irritation)
• Lack of activity (such as a broken arm in a sling)
• Chilling of areas of the body (eg, sitting under an air conditioning duct; sleeping in front of an air conditioner)
• Generalize fatigue (fibromyalgia is a perpetuating factor of CMP, perhaps chronic fatigue syndrome may produce trigger points as well)

The fascia is a tough connective tissue which spreads throughout the body in a three dimensional web from head to foot without interruption. The fascia surrounds every muscle, bone, nerve, blood vessel and organ of the body, all the way down to the cellular level. Therefore, malfunction of the fascial system due to trauma, posture, or inflammation can create a binding down of the fascia, resulting in abnormal pressure on nerves, muscles, bones or organs.

This can create pain or malfunction throughout the body, sometimes with bizarre side effects and seemingly unrelated symptoms. It is thought that an extremely high percentage of people suffering with pain and/or lack of motion may be having myofascial problems; but most go undiagnosed, as the importance of fascia is just now being recognized.

ANSWER: Pain originating in the muscles and fascia is very common. Nearly everyone at some point suffers from this type of pain, known as myalgia fascitis or myofascitis. CMP, however, involves pain that is chronic, or long lasting, and is associated with specific trigger points. CMP most often occurs in people between the ages of 30 and 60 years. It affects men and women equally.

ANSWER: To accurately diagnose Chronic Myofascial Pain (CMP), a thorough history and physical evaluation are essential. The history should include a detailed pain history, including when and how the pain started, the exact location of the pain, what it feels like, which treatment modalities have been attempted (and their results), and any history of trauma, overuse, or concurrent illness. The patient should point to the exact location of the pain, rate the pain on a scale of 0 to 10, and review what makes the pain better or worse.

Exam

A thorough physical examination should be performed, with a focus on the area of pain and discomfort. The physician should start by observing the patient's movements and posture, looking for poor posture, muscle strain, pain that increases guarding, and increased pain in other muscle groups. Trigger points cause muscle shortening with secondary weakness and decreased range of motion; therefore, a complete musculoskeletal exam with strength testing and relevant neurological assessment is essential. Tension and spasm in muscle groups should be assessed.

Identification

To make identification of trigger points easier, the patient should be as relaxed as possible. Trigger points can be felt by palpating the muscles; trigger points will consist of tender, hard (or ropy) knots or nodules surrounded by what feels like normal muscle tissue. Once a trigger point has been found, the local twitch response may be elicited as muscle or skin twitching. Next, the patient should be evaluated for referred pain. Knowledge of reference zones is essential to the diagnosis.

ANSWER: Yes, too much stress can cause additional problems for people with CMP. It is often listed as a factor in causing flares. Most specialists recommend minimizing stress.

In addition to the local or regional pain associated with CMP, people with the disorder also can suffer from depression, fatigue and behavioral disturbances.

ANSWER: To date, there is no published evidence that CMP is contagious or transmissible from person to person.

ANSWER: People with CMP may improve after a few months, or after many years, or never at all. They may reach a plateau at some constant level of health, or may progressively decline. Often, the symptoms change over time, or cycle irregularly.

In general, the outlook is good. When properly diagnosed and treated, the pain associated with CMP often can be controlled.

ANSWER: It might not be possible to prevent all episodes of CMP, but the following tips might help reduce their occurrence and hasten recovery:

• Improve your posture
• Reduce your body weight
• Exercise regularly
• Eat a healthy, well-balanced diet
• Learn stress-management techniques
• Use proper techniques at work, and during exercise and sports

ANSWER:

• Low Back Pain
• Neck &s Shoulder Pain
• Hip Pain
• Pelvic Pain
• Headaches
• Jaw Pain
• Upper Limb Pain
• Lower Limb Pain
• Chest & Abdominal Pain

CLICK HERE for more in-depth information about the symptoms of CMP.

ANSWER: This is one of those trick questions as the answer is both yes and no. Acute injuries with a short history can be cured and really do go away for good. More chronic injuries, many of which are due to years of poor ergonomics, may never completely go away.

The pain can be controlled and the disability minimized but lifelong stretching may be needed along with occasional trigger point work for acute flare ups. Completely correcting poor ergonomics is needed but seems impossible in many cases.

ANSWER: Several studies suggest that there may be a genetic component to CMP. The evidence on this point is not clear.

ANSWER: When muscles contract, they shorten. A trigger point is a microscopic part of the muscle that got stuck in a contracted state. They may feel like knots, nodules, hard lumps, or taut, ropy bands of fibers in the muscles. In very severe cases, muscle may feel like hardened concrete.

Trigger points may be active or latent. Active trigger points cause pain, and latent ones can be "recruited" into causing pain. While CMP is not progressive, it can appear to be since each trigger point can develop satellite and secondary trigger points, which can themselves form satellites and secondaries, and so on. This cascade is especially likely if perpetuating or aggravating factors are not identified and corrected.

CLICK HERE for more information about Trigger Points.