Myofascia | Síndrome Dolor Pélvico Crónico

Myofascial pain syndrome in the pelvic floor

Myofascial pain syndrome in the pelvic floor is a common condition, originally described by Drs Janet Travell and David Simons, involving the musculoskeletal system; there is a high percentage of misdiagnosis and a high failure rate of medical interventions and, therefore, of frustrated specialists and patients. The etiology includes urologic, gynecologic, gastrointestinal, proctologic, neurological, and musculoskeletal problems. Muscle injury can occur when soft tissues are exposed to single or persistent episodes of muscular overload. Myofascial pain syndromes are characterized by the development of myofascial trigger points that are locally painful when stimulated. These trigger points are hyperirritable spots within a taut band of hypercontractedextrafusal muscle fibers. The trigger point and the taut band can be palpated, which provokes the typical referred pain. Affected muscles are usually shortened and have an increased tone and tension. Diagnosis is done based on the history, physical examination, and neurophysiologic tests. Treatment requires medical, psychological, and physical therapies, including local infiltrations with lidocaine, dry needling, botulinum toxin injections, and several physiotherapeutic and psychological techniques.

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