The most common causes of back pain are found in your muscles, ligaments and fascia. Fascia is thin, fibrous layer of connective tissue that envelops muscles like a web throughout your body. When the fascia covering a muscle or group of muscles is injured, it can cause pain.

Repetitive motions such as those done on the job or in recreational activities — especially in the setting of poor conditioning or muscle imbalance — can cause myofascial pain syndrome.

Though muscle pain is common after many activities, myofascial pain syndrome is muscle pain that does not go away. It can also be caused by ongoing, stress-related muscle tension. Poor sleep, nicotine use and some medical conditions may also contribute to myofascial pain.

Symptoms include:

• A deep muscle ache or pain
• Pain doesn’t go away or gets worse
• A knot or “trigger point” that forms under the skin that is tender or painful when touched

Myofascial pain is often treated with some combination of:

• Relaxation techniques
• Hot packs or hot showers
• Massage
• Acupuncture
• Various oral medications
• Trigger point injections, which involves getting a shot of numbing medication or steroids directly into the muscle knot
• Increased aerobic conditioning and strengthening with attention to body mechanics
• Addressing sleep disturbances

Newer injection techniques such as platelet rich plasma injections have shown some promise, and are currently an area of significant research.

Physical therapy can be very effective in treating myofascial pain. Physical therapy can involve a combination of stretching exercises, posture training, exercises to strengthen muscles around the trigger point and ultrasound waves to promote healing. At our Spine Clinic, we design our physical therapy treatment plans based on each individual’s specific needs.

For more information about myofascial pain you can contact the Spine Center at Virginia Mason by calling (206) 417-7463.