Managing myofascial pain syndrome: sorting through the diagnosis and honing treatment.

Musculoskeletal complaints are among the leading reasons for visits to physicians, and about one third of these patients meet diagnostic criteria for myofascial pain syndrome (MPS). Although MPS was identified more than a century ago, debate over its existence as a separate clinical entity continues. Physicians who learn to identify characteristic symptoms can differentiate MPS from fibromyalgia and provide effective treatment. Key to treatment is identification of trigger points that when stimulated produce patterns of pain throughout a limb or region. Treatment modalities for MPS include trigger point injection, shiatsu, and the spray and stretch technique. Prognosis for MPS is better than that for fibromyalgia, and treatment usually follows an individualized regimen.