Myofascial Dysfunction Syndrome of Abdominal Fascia:
Helping to Manage Pain to Achieve Abdominal Myofascial Release
Abdominal Myofascial Pain-Dysfunction Syndrome (AMPS) is chronic myofascial pain in the abdominal wall, often a cause of refractory abdominal pain. It is characterized by the development of myofascial pain syndrome trigger points (areas of increased tenderness and irritability in the abdominal muscles). Transitioning into an active form, they become locally painful. Worse still, such pain radiates to other parts of the body and becomes an underestimated cause of nonspecific myofascial pain in the abdomen.
Myofascial muscle pain most often occurs in the upper abdomen just below the ribs or in the lower abdomen near the pubic bone. Most people experience discomfort during muscle exertion. Women feel discomfort in the groin area due to irritation of the pelvic muscles. Men may experience pain after surgery, such as hernia repair, because scar tissue makes the muscles less elastic.
The problem of myofascial disease has not only a medical aspect but also a socio-economic one, as it most often affects people of working age, leading to significant economic costs associated with treatment. Diagnosing and treating AMPS is a complex therapeutic issue that requires high medical costs.
Pathogenesis
of Myofascial Pain Disorders
Unlike myofascial pain in other locations, the nature of the onset of AMPS depends on the appearance of active trigger points in the fascia abdominal.
Clinically, myofascial pain trigger points are areas of increased sensitivity characterized by local muscle thickening and sharp pain during palpation. Thus, the term “myofascial pain syndrome” clearly reflects the localization of the pathological process (muscle or fascia) and indicates the presence of myofascial points.
Therefore, a trigger point is a pathognomonic sign of myofascial pain syndrome, which has clear clinical features: muscle spasms, areas of increased sensitivity, or “knots” in tense skeletal muscles, and localized pain. This condition leads to a reduced range of motion in the affected muscle and pain radiation zones.
Researchers identify three main phases of the course of myofascial pain-dysfunction syndrome:
- Acute. Acute thoracic myofascial strain caused by an active trigger point.
- Second phase. Characterized by the occurrence of pain only during movement and its absence at rest.
- Chronic. Has latent trigger points that retain the ability to reactivate. In such patients, muscle dysfunction and a constant feeling of chronic myofascial pain syndrome persist.
Among the main etiological factors in the development of myofascial dysfunction are:
- Injuries (physical, surgical).
- Spinal diseases (arthritis, osteoarthritis, hernias).
- Systemic disorders (dysmenorrhea).
- Psychological stress and muscle microtrauma (these conditions cause dysfunction of the motor end plate, leading to excessive excitation).
- Heavy physical work, especially prolonged static loads.
- Visceral inflammation in the anamnesis (gastritis, inflammatory bowel diseases, pancreatitis, endometriosis, cystitis) resulting from viscerosomatic convergence (VSC).
- Deficiency of B-group vitamins, folic acid, ascorbic acid.
- Eating disorders (especially hypovitaminosis B, C, as well as K and Mg deficiency).
- Diseases of internal organs.
- Chronic emotional stress.
For adequate therapeutic correction, the physician must identify these risk factors and causes leading to pain.
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Symptoms
of Abdominal Myofascial Syndrome
Signs of abdominal myofascial pain syndrome are classified as primary and secondary. Primary signs result from muscle damage, while secondary signs develop against the background of concomitant diseases, including internal organ disorders.
The main clinical manifestations of myofascial syndrome include:
- Pain sensations. Dull, throbbing, and intense pain in the affected muscle.
- Limited movement. Pain and muscle spasms may lead to restricted movement where trigger points are located.
- Myofascial spasm. Affected muscles weaken. Individuals may experience changes in the range of motion, worsened coordination, swelling, and joint clicking.
- Changes in skin condition. In the area of the affected muscle, the skin may become reddish or pale, with possible numbness, tingling, and prickling sensations.
- Muscle-tonic syndrome. General fatigue, insomnia, headaches, dizziness, and muscle tension often accompany the pain syndrome in the chest and neck and the abdominal area.
Myofascial dysfunction syndrome can complicate diseases of internal organs and joints, altering the expression of the primary pain syndrome. Increased anxiety and vegetative disturbances often include sleep disorders and a general feeling of discomfort.
Thus, muscle tension in gynecological diseases can cause pain in the lower back, lower abdomen, and lumbar muscles, while gastrointestinal diseases and kidney pathologies can cause pain in the paravertebral areas.
How to Diagnose
Myofascial Pain Disorders?
Most specialists often overlook myofascial abdominal pain. However, it shouldn’t be dismissed since it can accompany primary pathological conditions, causing referred pain to other parts of the body, or be a concomitant phenomenon of the main pathological process in the body.
To make a diagnosis, it is necessary to find a connection between pain and physical overload, tension, or hypothermia. Abdominal wall pain is associated with Carnett’s sign – acute local, punctate, or superficial pain provoked by physical movements of the abdomen (tension, bending, twisting). In addition to myofascial pain syndrome, compression of the anterior cutaneous nerve can be a source of pain in the abdominal wall.
Among the listed criteria, one of the main criteria for myofascial pain syndrome diagnosis is the presence of an active trigger point, pressing on which sharply intensifies pain—the “jump sign”.
To rule out the presence of pathologies of internal organs, a thorough examination, blood and urine tests, and radiographic studies are necessary. After excluding all possible problems, the most likely diagnosis will be fibrosis or inflammation of the abdominal muscles.
Make sure to consult with your doctor for proper diagnosis prior to taking any further actions.
The treatment of myofascial pain in the abdominal fascia should be comprehensive. The main goal of myofascial pain syndrome therapy is to eliminate the pathological process of muscle tension. Both symptomatic and physiotherapeutic treatments are used in therapy.
Myofascial pain treatments follow this algorithm:
- Therapeutic exercises. Exercises (such as stretching) aim to improve local blood and lymph circulation, tropism, relaxation, and stretching of spasmed muscles in the early stages.
- Therapeutic massage. Massage techniques are used to reduce pain syndrome, eliminate muscle spasms in the affected area, and accelerate the recovery of muscles subjected to maximum physical stress.
- Myofascial release. This form of stretching aims to develop the flexibility of muscles and tendons, as well as abdominal fascia release.
- Myopress therapy. Therapy with tennis balls helps deactivate trigger points.
- Diaphragmatic breathing. Psychological state correction.
- Physiotherapy. Acupuncture, manual therapy, electrophoresis, and shock wave therapy (only in cases where acute pain is absent) promote relaxation and pain reduction.
- Sauna. Alleviating soreness after myofascial release and tension in muscle groups subjected to maximum physical stress.
The effectiveness of myofascial pain syndrome relief methods is individual for each patient. To prevent recurrences of myofascial pain, it is advisable to lead an active lifestyle, perform morning exercises, adhere to proper nutrition, a daily routine, rest, and abstain from harmful habits.
Myofascial release, adapted for each patient, in combination with therapeutic exercises and massage, helps to relieve pain in the abdominal fascia. The use of additional exercise equipment helps restore mobility and metabolism in tissues.
If you have any questions or would like to attend a myofascial release session, please contact our studio. We will help you regain activity, vitality, and joy of movement!
