Myofascial pain syndrome

Myofascial pain syndrome is a long-lasting, regional muscle pain attributed to trigger points: sensitive spots within tight bands of muscle that cause pain on the spot and can send it elsewhere (Steen et al., 2025). In everyday speech they are the “knots” people feel in their shoulders. The term “myofascial trigger point” was coined in the mid-20th century by Janet Travell together with her colleague Rinzler, although descriptions of hard, painful spots in muscle go back to 1600 (Bordoni et al., 2025).

What are trigger points?

They are described as hard, palpable nodules in a tight band of muscle, tender to pressure and to movement. An active trigger point hurts without being touched; a latent one hurts only when pressed (Bordoni et al., 2025).

Because definitions varied, 60 experts from 12 countries tried to agree on them. They settled on three essential criteria: a taut band, a hypersensitive spot and referred pain. Most agreed that the referred sensation need not be pain alone, but could be a dull ache, tingling or burning, and that no fixed pattern of where it spreads should be expected (Fernández-de-las-Peñas & Dommerholt, 2018).

Myofascial pain syndrome in desk workers

In 305 municipal office workers who used a screen for at least four hours a day, a physiotherapist found active trigger points in the right trapezius in 40% of them (54% of the women and 25% of the men), in the left trapezius in 35% and in the right sternocleidomastoid in 20%. People with higher neck and back disability scores were more likely to have them (Poveda-Pagán et al., 2026). A recent review lists muscle overuse, postural imbalance, other medical conditions and psychological and behavioural factors among the things thought to contribute (Steen et al., 2025).

Why myofascial pain syndrome is debated

• Examiners disagree. A review of nine studies found that agreement between examiners varied widely. It was better for tenderness than for the taut band or the “twitch” that is supposed to accompany it, and the authors concluded that examination by touch could not yet be recommended as a reliable test (Lucas et al., 2009). That matters for prevalence figures like the 40% above, which rest on examination by touch.
• The theory has strong critics. One critical review argued that trigger points as a distinct physical abnormality have no scientific basis, while stressing that the pain and tenderness themselves are real and can be explained by known nerve physiology (Quintner et al., 2015).
• The cause is still open. Even supportive reviews say the mechanism and diagnostic criteria are still under investigation, and that the condition overlaps with fibromyalgia, nerve pain and joint problems (Steen et al., 2025).

What helps?

The 2025 review found sufficient evidence for local anaesthetic injections, and some evidence for dry needling, acupuncture, manual therapy and several physical treatments, mostly compared with sham. Evidence was insufficient for anti-inflammatory painkillers and TENS, and inconclusive for kinesiology tape (Steen et al., 2025).

Exercise is the option you can do yourself. In 48 women with chronic trapezius muscle pain, recruited from workplaces with monotonous jobs such as computer work, ten weeks of specific strength training for the painful muscle cut their worst pain by about 79%, while general fitness training on a bike gave only a small, short-lived drop (Andersen et al., 2008). The trial was small, and its diagnosis was trapezius myalgia rather than trigger points as such. More in Is two minutes of exercise enough? and Does massage help neck pain?

When to see a doctor

See a GP if pain is widespread rather than in one area, especially with tiredness, poor sleep or trouble concentrating, which can point to fibromyalgia (NHS). For neck and shoulder pain, see a GP if it hasn’t gone after a few weeks, painkillers haven’t helped, or you have pins and needles or a cold arm (NHS). Pain that is long-lasting or spreading is covered under chronic pain, and the common desk pattern under neck pain from desk work.