Multimodal approach to managing patients with myofascial pain syndrome

Vollständiger Abstract

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Myofascial pain syndrome (MPS) is a common disorder involving localized or referred pain that originates from trigger points in muscles and fascia. In many cases, its treatment is either inappropriate or delayed, leading to a reduced quality of life for patients. This is due to incomplete comprehension of the mechanisms underlying myofascial pain, the lack of uniform diagnostic criteria, and the absence of standard treatment protocols. This review aims to summarize, systematize, and evaluate the available data on treatment and rehabilitation methods used in clinical practice for patients with MPS. Numerous systematic reviews, meta-analyses, and individual studies were analyzed revealing that pharmacological methods include the oral administration of nonsteroidal anti-inflammatory drugs, opioid analgesics, muscle relaxants, antidepressants, and antiepileptic drugs. Topical anesthetics are also used in these approaches, either in the form of patches or creams; as well as injections into trigger points. Among the physical methods are dry needling, acupuncture, manual therapy, kinesiotherapy, shockwave therapy, electrical muscle stimulation, magnetic stimulation, phototherapy, and ultrasound therapy. As first-line therapy, topical anesthetics combined with non-invasive physical methods can be considered. MPS treatment requires a comprehensive and personalized approach. Positive treatment results and patient recovery depend on rehabilitation measures, particularly regular exercise, psychological support, and a healthy lifestyle.