Overview
Myofascial pain syndrome is a chronic pain condition caused by sensitive trigger points — tight, tender knots in muscle and surrounding fascia — that produce local and referred pain patterns. Myofascial pain is extremely common: it is estimated to be a contributing factor in over 85% of chronic pain presentations and is frequently overlooked or undertreated in conventional medical settings. Dr. Migdale's background as a certified massage therapist and chiropractor for over a decade gives her a uniquely sophisticated understanding of myofascial pain — and her interventional training allows her to treat it at every level, from manual therapy to guided injection.
Understanding Trigger Points
A trigger point is a hyperirritable spot within a taut band of skeletal muscle — typically felt as a nodule or tight cord within the muscle. When compressed, trigger points produce characteristic referred pain patterns that can mimic radiculopathy, joint pain, or other conditions. For example, trigger points in the gluteal muscles can mimic sciatica; trigger points in the suboccipital muscles can mimic migraine; and trigger points in the chest wall can mimic cardiac pain.
Why Myofascial Pain Is Often Missed
Myofascial pain does not appear on MRI or X-ray. It requires a careful physical examination by a clinician who knows how to identify trigger points and their referred pain patterns. In many medical settings, where imaging-driven diagnosis dominates, myofascial pain goes unrecognized — leading to unnecessary procedures targeted at structural findings that may not be the actual pain source.
Treatment: From Hands to Needles
Dr. Migdale's treatment of myofascial pain draws on her full background. Manual therapies — including Graston Technique (instrument-assisted soft tissue mobilization), myofascial release, and Active Release Technique (ART) — address the fascial and muscular components directly. For persistent or severe trigger points, trigger point injections (with local anesthetic, with or without corticosteroid) or dry needling can provide rapid relief. Medical acupuncture is also highly effective for myofascial pain.