Myofascial pain

Can anyone explain to me about myofascial pain please as I often hear it mentioned on this site and wonder if it fits my symptoms. I have had PMR for just over 18 months and it has responded well to prednisolone. I am now on 5.5mg and have used the DSNS system nearly all the way. However the leg pain on standing and walking which started a while after the onset of PMR persists. It is nothing like polymyalgia pain. I have had an MRI and apparently my back is OK. When and where does myofascial occur? How does it feel? Does it respond to steroids? Any advice would be gratefully received. Thank you to everyone on this site which has been my main - no only - source of help and support throughout.

16 Replies

  • If I remember rightly this is pretty good as an explanation:

    It will respond to some extent to higher doses of pred but then return or get worse as you reduce the dose.

    Mostly it can lead to pairs of trigger points on either side of the spine in shoulders, about rib level and in the low back - they hurt in their own right but can also irritate local nerves and cause referred pain as a result. It is a very common cause of sciatic problems - and spasmed muscles don't show up on imaging. It[s a clinical diagnosis and good pain specialists and physios will do it as well as help with treatment. Bowen therapy often also provides some relief - you might like to message this lady

  • PMRpro - can a physio achieve the same result as a Bowen Therapist? They are so thin on the ground where I live, plus I can claim on my medical insurance for a physio?

    Oh yes great answer to MaryW's question - as always :)


  • If you can find a physio who listens and knows about myofascial pain syndrome, yes. The one I saw left the job half-done on the grounds it would now clear - it didn't, it got worse again, but they did do useful work on the trigger points. In Germany it was a sports massage therapist who got it nearly done - but I moved back to the UK a short time too soon! There are physios who say they do myofascial release therapy - they obviously would be ideal.

  • Thank you PMRpro. That's very helpful and more and more I think this may be my problem. I did have some Bowen therapy in the past and didn't feel it was helping much but since I stopped it's got worse so it was obviously achieving more than I thought. I'm going back today to see her again. Also I will take your advice and see a good Physio as the gp isn't particularly interested - I can walk so what's the problem!

    Many thanks

  • A "musculoskeletal specialist" (aka physiotherapist with an extra bit of paper) told me quite rudely that since I could touch my toes and he couldn't there was nothing wrong! I did already have PMR as well at the time but neither he nor a rheumatologist recognised it.

    When it is really bad MPS will often need more than just Bowen - but every little helps...

  • Thank you PMRpro for your most helpful explanation of MPS & piriformis syndrome.

    Think I will need to post a new thread re my present hip/muscle situation.


  • Follow this link:

    and in the Summer Newsletter, page 11 read this article:

    Some Add-Ons to PMR: Myofascial Pain Syndrome and Piriformis Syndrome

    A more extensive article written by PMRpro specifically for PMR&GCA North East Support, Charity Reg No 1138409.

    PMRpro was co-author of the 'Living with PMR & GCA' booklet.

    You can click on the map on the home page and see if their is a support group near you.

    We and other support groups do take out of area email members.

  • Thank you very much. A very useful article.

  • How wonderful to read the Summer newsletter and what wonderful informative support there is in the UK and abroad - what would we do without PMRpro?

    God bless you all from Auckland NZ :)

  • You can read all the back Newsletters, which are full of information, tips and tricks etc.

    The rest of the site is good reading as well.

  • Wonderful sambucca, I sincerely appreciate your message and I will feast thine eyes upon these back Newsletters. Do I follow the link you supplied to Mary WR 2 threads back?

    Blessings :)

  • Yes or this one - straight toHome Page.

  • I'll tag onto the end here and present my case as to whether it's myofacial pain 😳😊....I was originally diagnosed with a large gluteal tear in my right hip. I had home physio, just stretches to do, then went to a clinic and had ultrasound, cupping, felt a lot better. I got so I'll I was in bed all spring and early summer. After getting out of bed, walking became impossible, even weight baring. The pain was excruciating, it now went into my lower back and left hip, brought tears to my eyes. I hobbled, crawled, used a wheelchair, two canes,....X-rays a week ago showed nothing but mild osteoarthritis which was there before. So back at physio and having Laser treatment, gentle bicycle riding (which is good, no pain at all) but other than that nothing. NO ONE in the physio clinic has looked up PMR yet despite my frequent asking.... I have a very large "bump", big enough to fill my hand at the side of my hip and had no answers from anyone except the pain specialist who said it was 'probably ' muscle.....NO ONE has even looked at it, just listened and nodded their head......I have read all the links,....any ideas? Oh and I have very painful elbows? Sorry for the novel, try to explain the whole picture. Thank you so much for any assistance.


  • Just wondering if the "bump" is really hard? It could be muscle - tightly spasmed muscle which needs to be released. A few of us have had what's called "dry needling" which, incomprehensible to me, "resets" the electrical signals in the muscle and releases the spasm. Had this done for the muscles along my spine. It's not the same as acupuncture, but similar needles are used. You would need to find an experienced physiotherapist or similarly trained medical person to do this for you.

  • Like Heron I've had needling done for my back muscle problems - very effective! Rather painful fleetingly at the time but it works so well patients willing go back for more! The first time my German GP did it, the last time it was the pain clinic in the local hospital.

    But you need to find someone to take muscular problems seriously - they don't show up on most imaging so for many doctors don't exist. And muscular problems can lead to sciatic nerve problems - which is what sounds possible.

  • Thank you PMRpro, I will start asking around.



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