Myofascial pain of the head and neck: diagnosis and management.

Myofascial pain (MFP) is a regional muscle pain disorder characterized by localized muscle tenderness and pain and the most common causes of persistent pain in the head and neck. The affected muscles may also display an increased fatigability, stiffness, subjective weakness, pain in movement, and slight restricted range of motion that is unrelated to joint restriction. MFP is frequently overlooked as a diagnosis because it is often accompanied by signs and symptoms in addition to pain, coincidental pathology conditions such as joint disorders, and behavioral and psychosocial problems. As MFP persists, chronic pain characteristics often precede or follow its development. Evaluation of myofascial pain includes locating the trigger points and muscles involved as well as recognition of these contributing factors. Management of the syndrome naturally follows with muscle exercises, therapy to the trigger points, and reducing all contributing factors. The difficulty in managing MFP lies in the critical need to match the level of complexity of the management program with the complexity of the patient.