Myofascial Pain Syndromes: Identifying Cases You Can Treat and Avoiding Useless Surgeries

TRACK: OEM Clinical Practice

Constantine Gean, MD, MS, MBA, FACOEM, Liberty Mutual, Glendale, CA
Stephen Levit, MD, Liberty Mutual, Glendale, CA
Craig E. Morris, DC, DACRB, FAFICC, CSCS, FIRST Health Clinic, Torrance, CA
Jules Steimnitz, MD, PM&R, San Francisco, CA

Myofascial pain is a common diagnosis but commonly is both poorly treated and poorly understood. This is particularly important as misdiagnosis of myofascial conditions often results in ineffective procedures or surgeries (e.g., when patients remain symptomatic after carpal tunnel and cubital tunnel releases, extensor tendon releases, shoulder surgery and even neck fusions). There are several common clinical myofascial syndromes that, if properly diagnosed, can be treated non-operatively by the primary care physician. This session will cover the following areas: an overview of current research on myofascial pain syndromes and explanation of the evolution of understanding of this condition over the last 50 yrs; how to recognize myofascial pain syndromes, including a basic diagnostic decision tree for primary care providers; and discussion of 6 nonoperative myofascial syndromes mimicking surgical conditions, including diagnostic tests and insights to help distinguish these from operative conditions. Treatments for myofascial pain syndromes including a basic protocol for myofascial patients; discussion of TPI, manual, biofeedback and other techniques; and myofascial pain resource.