Neck (Cervical)
Myofascial Pain Syndrome
근막통증증후군
Pain caused by trigger points within muscles
- How common
- Very common
- Typical age
- All ages
What is it?
Muscle overuse or stress leads to trigger point formation within muscles, causing local pain and referred pain.
Commonly affected: Most commonly affects the upper trapezius, levator scapulae, and sternocleidomastoid
How it develops
- Muscle overuse/stressSustained tension or repetitive motion causes an intramuscular energy crisis
- Trigger point formationA hypersensitive nodule (taut band) forms within the muscle fibers
- Local painPressure on the muscle elicits severe tenderness (jump sign)
- Referred painPain radiates from the trigger point to distant sites
Symptoms
- Severe tendernessPressure on specific points elicits intense 'startle' pain (jump sign)
- Localized muscle painTightness and pain around the trapezius and levator scapulae
- Referred headacheHeadache radiating to the temporal and occipital regions
- Restricted range of motionCervical motion limited by pain
- FatigueGeneralized fatigue from muscle tension
How it is examined
- Trigger point palpationIdentify a tender spot within a taut band → jump sign
- Referred pain confirmationPressure on the trigger point reproduces pain in a specific referred area
- Normal neurological examNormal strength, sensation, and reflexes (no nerve compression)
Imaging
Plain X-ray is usually normal.
- Most often normal findings
- Possible cervical malalignment in long-standing cases
MRI is usually normal or nonspecific. Performed to exclude other conditions.
- No specific intramuscular findings
- Confirmation of no nerve compression
Non-surgical care
- Trigger point injectionDirect treatment with 0.5% lidocaine or dry needling of the trigger point — most effective
- StretchingUpper trapezius and levator scapulae stretching at least 3 times a day
- Posture correctionAdjusting monitor and chair height; training to keep the shoulders down
- Heat therapyMuscle relaxation with hot packs and warm showers
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
No surgical indication
Procedures that may be discussed
- Surgery not required
Outlook
Good prognosis with treatment and posture correction. Regular exercise and stress management are key to preventing recurrence.