Síndrome de dolor miofascial: diagnóstico y tratamiento

Abstract

Myofascial pain syndrome (MFS) is one of the most common causes of acute and chronic
musculoskeletal pain as well as temporary or permanent disability. At least 30% of the
population presents some symptom in the musculoskeletal system in which pain of
muscular origin is of significant importance and represents 90% of the patients who
attend pain clinics. It is a non-inflammatory disorder, of muscular origin located in a
muscle or muscle group, characterized by pain in the corresponding muscle area, more
referred pain and the presence of a band of tension, painful and increased in consistency,
which is identified at the palpation. In this band is the trigger point (PG) or trigger point.
Some factors such as acute trauma, repeated microtrauma, lack of exercise, improper
and maintained posture, vitamin deficiencies, sleep disturbances, and joint problems
predispose the appearance of trigger points. Myofascial pain syndrome is an acute or
chronic, primary or secondary, prevalent, disabling, underdiagnosed, and therefore
under-treated regional muscular process. The etiology of PG trigger points is due to a
dysfunction of the motor endplate as a result of its abnormal depolarization. Patients with
MFS and with active PG trigger points present with persistent localized or regional pain
that mainly affects the muscles of the neck, shoulders, and pelvic girdle. Sometimes they
can be associated with autonomic symptoms. The diagnosis is based on an adequate and
thorough physical examination as well as a detailed and exhaustive medical history. The
diagnostic criteria applied in the diagnosis are the painful nodule in the tight band, the
recognition of pain by the patient, the characteristic pattern of referred pain and the jump
sign. Musculoskeletal ultrasound is currently used for diagnosis with the help of a tuning
fork at 128 cps. Treatment is pharmacological and non-pharmacological. This must be
individualized and multidimensional; and it depends on the intensity and duration of the
pain. The purpose of this article is to establish a diagnostic and management guide in
patients with myofascial pain syndrome.