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Joint Pain and Myofascial Pain Disorder (MPD)

written by: LaurieBoris • edited by: Diana Cooper • updated: 10/17/2010

You can't lift as much as a shampoo bottle without pain and stiffness; in fact, every movement is a misery. That's life with myofascial pain disorder (called MPD or sometimes MPD joint pain), a poorly understood condition that can diminish range of motion and the joys of everyday life.

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    What is Myofascial Pain Disorder?

    The musculature of your body is contained within a flexible netting of membranes called fascia. Together with the muscles, this is called the myofascial system. In most people, the system works quite well. You can stretch out an arm or leg, confident that your muscles and fascia will move smoothly and pain-free to accomplish your task. But in about twenty percent of people (some experts say this could be up to fifty percent), myofascial pain disorder, often called myofascial pain syndrome, develops. MPD is marked by muscle pain and stiffness upon movement. MPD joint pain can also develop.

    What Causes MPD?

    While specialists aren't clear on the exact causes of myofascial pain disorder or how it causes pain in certain joints, there are several theories of how pain develops due to the dysfunction of the system. Most experts agree that knots (often referred to as trigger points) develop in your muscles and fascia, which limit range of motion. For instance, because the trigger point restricts your ability to stretch a muscle to its end point, you may not be able to raise your arms high enough to wear certain types of clothing, or reach up to a kitchen shelf without stiffness and pain. The trigger points that limit mobility are highly sensitive and often cause referred pain, meaning that when pressed, pain is felt elsewhere in the body.

    What Causes MPD Joint Pain?

    Myofascial pain disorder can occur in any skeletal muscle. The taut bands and trigger points present in MPD can create pain in joints either by referred pain, or, it is believed, simply by muscle tension pulling a joint out of alignment. TMJ (temporal mandibular joint) syndrome is one proven case of how dysfunctional muscles and myofascia pull a joint (in this case, the connection of your lower jaw) out of alignment, causing muscle pain, spasms, headaches and difficulty chewing.

    How is MPD Treated?

    Treatment typically starts by neutralizing the trigger points. Medication is only useful for pain management in MPD, so the knots must be removed manually. A therapist can do this with specialized massage strokes, and acupuncturists or other trained professionals may release the knots by injection in a technique called dry needling. Then, your therapist may address underlying conditions that could have contributed to myofascial pain and trigger points, such as skeletal imbalances, chronic fatigue, repetitive strain injuries, inactivity (perhaps a broken leg or arm in a cast), poor posture, or lack of exercise.

    Once trigger points are treated, you will need to follow an appropriate stretching and exercise program that will manage your myofascial pain and keep your muscles and fascia healthy and your joints in alignment. It's vital to stretch daily - but never to the point of pain - and to avoid staying in one position for a long time. MPD joint pain can be difficult to completely eradicate, but with good treatment and body mechanics, it can be well managed.

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    References

    Cervical Myofascial Pain http://emedicine.medscape.com/article/305937-overview

    Temporomandibular Joint Syndrome http://emedicine.medscape.com/article/809598-overview

    Myofascial Pain Syndrome http://www.webmd.com/pain-management/guide/myofascial-pain-syndrome