What Is Myofascial Pain Syndrome? A Plain-Language Guide to the Muscle Pain That Won't Quit
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: Key Facts About Myofascial Pain Syndrome
Myofascial pain syndrome is a long-term pain condition involving muscles and the fascia covering them, in which pressure-sensitive knots called trigger points cause pain, often felt far from the knot. [1] There is no single known cause, though repeated muscle use, poor posture, injury and stress may contribute. [1] Treatment combines medicines, trigger point shots, physical therapy and exercise. [2]
Question | Answer |
What it is | A long-term pain condition involving muscles and the thin tissue covering them, called fascia, where pressure-sensitive knots (trigger points) cause pain. [1] |
Where you feel it | Often as "referred pain" — pain felt far from the knot — most often as shoulder pain, back pain, tension headaches, or face pain. [1] |
What causes it | There is no single known cause. Repeated muscle use, poor posture, muscle injury, and mental stress all appear to help form trigger points. [1] |
How it's treated | Usually a combination of medicines, shots into the trigger points, physical therapy, and daily exercise. [2] |
Outlook | Most people can manage it. Gentle stretching, massage, relaxation, and good sleep habits are part of every treatment plan. |
What the research says
Myofascial pain syndrome is very common and still poorly understood. A comprehensive review reports that it frequently presents as a chronic condition and may affect up to 85% of adults during their lifetime. It is often overlooked, remains challenging to treat, and is more common in people with other chronic pain disorders. Non-drug approaches such as acupuncture, massage, transcutaneous electrical stimulation, and interferential current therapy may offer relief to some patients. (Galasso et al., Curr Pain Headache Rep, 2020 [3])
Physical therapy tools have promising but still-developing evidence. A systematic review of 25 randomized controlled studies found that TENS, extracorporeal shock wave therapy, laser therapy, and other physical modalities improved pain, joint mobility, psychological state, and quality of life, with no side effects reported. The authors noted there is no consensus yet on the best treatment approach, settings, or combinations, and called for higher-quality trials. (He et al., BMC Musculoskelet Disord, 2023 [4])
What Is Myofascial Pain Syndrome, in Plain Language?
Myofascial pain syndrome is a long-term pain condition. It involves some muscles and the thin cover of tissue that holds muscles in place, called fascia. Pressure on these areas, called trigger points, causes pain. [1]
A trigger point feels like a tender knot inside a muscle. When you press on it, it hurts. Sometimes the pain is felt in other parts of the body entirely. [1] This is called referred pain.
Think of it this way: a knot in your neck muscle might send pain up into your head, where you feel it as a tension headache. The source is the neck, but the hurt is in the face or scalp.
This is what makes the condition so confusing. The pain of myofascial pain syndrome often is felt as shoulder pain, back pain, tension headaches, and face pain. [1] People can have it for a long time without realizing it comes from knots in their muscles.
How Is It Different From Normal Muscle Soreness?
Almost everyone has felt muscle tension pain. The difference is in how long the pain lasts. The pain of myofascial pain syndrome doesn't go away. [1]
Feature | Normal muscle soreness | Myofascial pain syndrome |
How long it lasts | Goes away with rest, massage, and self-care | Doesn't go away on its own |
What causes it | A hard workout or strain | Trigger points (tender muscle knots) |
Where you feel it | At the sore muscle | In the muscle, or as referred pain far from it |
What a knot feels like | A general tight area | A tender knot that hurts when pressed |
What Does Myofascial Pain Syndrome Feel Like?
Myofascial pain syndrome may cause a number of different symptoms, including those listed next.
Symptom | What it means in plain language |
Deep, aching pain in a muscle | The pain feels deep inside the muscle, not on the surface |
Pain that doesn't go away or gets worse | Rest doesn't fix it; it persists or grows over time |
A tender knot in a muscle | You can often feel a small, sore lump in the muscle |
Trouble sleeping due to pain | The pain makes it hard to fall asleep or stay asleep |
Malaise | A general feeling of being unwell |
Tiredness | Feeling worn out more often than usual [1] |
What Causes Myofascial Pain Syndrome?
The exact cause of myofascial pain syndrome is not known. [1] Here is what doctors do know.
Areas of tight muscle fibers, called trigger points, form in muscles. Too much use of the muscles, most often with poor form, injury to the muscle, and mental stress likely help cause trigger points. [1]
The syndrome can happen after a muscle has been tensed over and over. Repeated motions used in jobs or hobbies can be the cause. [1] So can stress-related muscle tension, poor posture, and weak muscles. [1] In some cases, the cause of myofascial pain is unknown.
Who Is at Higher Risk?
In myofascial pain syndrome, something such as muscle tightness sets off trigger points in the muscles. Two main factors may increase the risk of muscle trigger points.
Risk factor | How it raises the risk |
Muscle injury | A muscle injury or ongoing muscle stress may lead to trigger points. A spot in or near a strained muscle may become one. Repeat motions and poor posture also increase the risk. [1] |
Stress and anxiety | People who often feel stressed and anxious may be more likely to get trigger points. One theory is that these people tend to clench their muscles, and clenching is a form of repeated strain that leaves muscles open to trigger points. [1] |
Can Myofascial Pain Syndrome Lead to Other Problems?
Myofascial pain syndrome can disrupt sleep and, in some people, may be linked to another chronic pain condition. Complications linked to myofascial pain syndrome include:
Complication | What happens |
Sleep problems | Symptoms may make it hard to sleep. It might be hard to find a good sleep position, and if you move while sleeping, you might hit a trigger point and awaken. [1] |
Fibromyalgia | Some research suggests that myofascial pain syndrome may lead to fibromyalgia in some people. Fibromyalgia is a long-term condition of widespread pain. It's believed that the brains of people with fibromyalgia respond more to pain signals over time, and some experts believe myofascial pain syndrome might help start this process. [1] |
When Should I See a Doctor?
Most people have muscle pain at times. But if your muscle pain doesn't go away with rest, massage, and other self-care measures, make an appointment with your healthcare professional. [1]
How Is Myofascial Pain Syndrome Diagnosed?
During a physical exam, your healthcare professional may put gentle finger pressure on the affected muscle, feeling for painful areas. Certain ways of pressing on the trigger point can cause certain responses. For instance, you might have a muscle twitch. [2]
Muscle pain has many possible causes. Your healthcare professional uses other tests and procedures to rule out other causes of muscle pain. [2]
The symptoms of myofascial pain syndrome are like those of other disorders. So you may see more than one healthcare professional before getting a diagnosis. [2]
How Is Myofascial Pain Syndrome Treated?
Treatment for myofascial pain syndrome typically includes medicines, shots into the trigger points, and physical therapy. Exercise is a big part of any treatment plan. [2]
Discuss treatment options and what you prefer with your healthcare professional. You may need to try more than one approach to find pain relief. [2]
What Medicines Help?
Medicine type | What it does and key points |
Pain relievers | Over-the-counter options such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may help. Some come as creams or patches you put on the skin, or your healthcare professional may prescribe stronger pain relievers. [2] |
Antidepressants | Many types of antidepressants can help relieve pain. For some people, amitriptyline seems to reduce pain and improve sleep. [2] |
Sedatives | Clonazepam (Klonopin) and other benzodiazepines help treat the anxiety and poor sleep that sometimes come with this condition. These medicines can cause sleepiness and can be habit-forming. They carry an FDA boxed warning for misuse, dependence and dangerous withdrawal, and taking them with opioids or alcohol can cause life-threatening breathing problems. [2] |
What Does Physical Therapy Involve?
A physical therapist can help relieve your pain based on your symptoms.
Stretching. A physical therapist may lead you through gentle stretches to help ease the pain in your sore muscle. If you feel trigger point pain when stretching, the therapist may put a numbing spray on your skin. [2]
Massage. A physical therapist may massage your affected muscle to help relieve your pain. The therapist may use long hand strokes along your muscle or place pressure on areas of your muscle to release tension. [2]
What Procedures Are Used?
Procedure | How it works |
Shots (injections) into trigger points | A shot of a numbing medicine or a steroid into a trigger point can help relieve pain. Botox (onabotulinumtoxinA) also might be used. [2] |
Dry needling | In some people, just putting the needle into the trigger point helps break up the muscle tension. Acupuncture also appears to help some people. [2] |
TENS | Transcutaneous electronic nerve stimulation sends a tiny electrical current to painful areas through electrodes taped to the skin. It's not known how TENS relieves the pain, and more study is needed. [2] |
Ultrasound | This therapy uses sound waves to increase blood flow and warmth, which may reduce pain in the affected muscles. [2] |
Extracorporeal shock wave therapy | Sound waves are directed at the area of pain. Some studies have shown it to ease pain in myofascial pain syndrome. [2] |
What Can I Do at Home?
Keeping your body healthy may make it easier for you to cope with your pain.
Exercise. Gentle exercise can help you cope with pain. When your pain allows, get moving. Ask your physical therapist or another member of your healthcare team about good exercises for you. [2]
Relax. If you're tense, you may feel more pain. Find ways to relax. Do deep breathing. Meditate. Write in a journal. Talk with friends. Do what helps ease your stress. [2]
Take care of your body. Eat a healthy diet full of fruits and vegetables. Get enough sleep. [2]
How Do I Cope With Living With It?
Having a long-term pain condition such as myofascial pain syndrome can be upsetting. It may help to talk to a counselor about what you're facing. Online or in-person support groups also can be helpful. They can link you to people who know what you're going through. [2]
How Should I Prepare for a Doctor's Appointment?
You're likely to start with a visit to your primary healthcare professional. [2] You might then be sent to a specialist in muscle and joint conditions, called a rheumatologist.
Here are some things you can do to get ready for your appointment.
What to bring | What to include |
Your symptoms | List them and when they began |
Your key medical information | Include other conditions you have, plus all medicines, vitamins, or supplements you take, including doses [2] |
Questions to ask | See the list below |
For myofascial pain syndrome, some basic questions to ask include:
What might be causing my symptoms?
Is my condition likely to go away on its own?
Do I need treatment?
What treatments are there?
Do you have brochures or other printed material that I can have? [2]
Your healthcare professional is likely to ask you questions, such as:
Your doctor may ask | Why it matters |
Where do you feel the most pain? | Helps locate the trigger points |
Do your symptoms come and go, or do you always have them? | Shows the pain pattern |
Does anything seem to make your symptoms better? | Points to what helps |
Does anything seem to make your symptoms worse? | Points to triggers like posture or repeated motions |
Are your symptoms worse in the morning or at any other time of the day? | Helps with diagnosis |
Do you use repeated motions on the job or for hobbies? | A likely contributor to trigger points |
Have you been injured recently? | Muscle injury is a known risk factor |
How does your pain limit what you can do? | Shows how much the pain affects daily life |
What is the bottom line on myofascial pain syndrome?
Myofascial pain syndrome is a long-term condition caused by tender knots in muscles called trigger points. The pain often doesn't go away with rest, and it can show up as referred pain in the shoulder, back, face, or as tension headaches. But it can be managed. Treatment typically combines medicines, trigger point injections, physical therapy, and daily exercise, along with simple home habits like relaxing and sleeping well. If your muscle pain won't quit, the next step is a conversation with your healthcare professional.
Ready to get answers about your muscle pain? If your pain doesn't go away with rest and massage, the next step is to talk with a healthcare professional. They can find the trigger points, rule out other causes, and build a treatment plan that fits your life.
Frequently Asked Questions
What is myofascial pain syndrome in simple terms?
Myofascial pain syndrome is a long-term muscle pain condition. Tender knots called trigger points form in the muscle and the thin tissue covering it. Pressing on these knots causes pain, and the pain often doesn't go away with rest.
Why does my muscle pain feel like it's in my shoulder or head, not my neck?
Pain felt in the shoulder or head is called referred pain. A trigger point in one muscle can make you feel pain in another part of the body. Myofascial pain syndrome is often felt as shoulder pain, back pain, tension headaches, and face pain.
Is myofascial pain syndrome dangerous?
Myofascial pain syndrome is not considered dangerous, but it doesn't go away on its own. Most people have muscle pain at times, but the pain of this condition persists. Some research suggests it may be linked to fibromyalgia, a long-term condition of widespread pain, in some people.
What causes the trigger points?
The exact cause is not known. Too much use of the muscles with poor form, muscle injury, and mental stress likely help cause them. Repeated motions in jobs or hobbies, stress-related muscle tension, poor posture, and weak muscles can all contribute. In some cases, the cause is unknown.
What's the first treatment doctors usually recommend?
Treatment typically includes medicines, shots into the trigger points, and physical therapy. Exercise is a big part of any treatment plan, and you may need to try more than one approach to find pain relief.
Do the injections really help?
A shot of a numbing medicine or a steroid into a trigger point can help relieve pain. In some people, even the act of putting a needle into the trigger point (dry needling) helps break up the muscle tension.
Can stress really cause muscle pain?
Yes. People who often feel stressed and anxious may be more likely to get trigger points, possibly because they tend to clench their muscles, and clenching is a form of repeated strain.
What should I do if the pain is ruining my sleep?
Talk to your healthcare professional. Sleep problems are a known complication because a good sleep position may be hard to find and moving during sleep can hit a trigger point and awaken you. Relaxation habits, enough sleep, and certain medicines may help.
How is myofascial pain syndrome different from fibromyalgia?
Myofascial pain centers on trigger points in specific muscles, while fibromyalgia causes widespread pain throughout the body. Some research suggests myofascial pain may lead to fibromyalgia in some people, and a provider can help tell them apart.
How is myofascial pain syndrome diagnosed?
A provider usually diagnoses it with a physical exam, pressing on muscles to find tender trigger points that reproduce your pain. There is no single blood or imaging test for it, but tests may be used to rule out other causes.
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References
Mayo Clinic Staff. Myofascial pain syndrome: Symptoms & causes. Mayo Clinic. January 5, 2024. https://www.mayoclinic.org/diseases-conditions/myofascial-pain-syndrome/symptoms-causes/syc-20375444
Mayo Clinic Staff. Myofascial pain syndrome: Diagnosis & treatment. Mayo Clinic. January 5, 2024. https://www.mayoclinic.org/diseases-conditions/myofascial-pain-syndrome/diagnosis-treatment/drc-20375450
Galasso A, Urits I, An D, et al. A Comprehensive Review of the Treatment and Management of Myofascial Pain Syndrome. Curr Pain Headache Rep. 2020;24(8):43. PMID 32594264. https://doi.org/10.1007/s11916-020-00877-5
He P, Fu W, Shao H, et al. The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: a systematic review. BMC Musculoskelet Disord. 2023;24(1):376. PMID 37173661. https://doi.org/10.1186/s12891-023-06418-6
Medical disclaimer
This article is for general informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment decisions.
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