A: The primary treatments for MFPS are:
Exercise and stretching
Exercise remains the primary treatment for MFPS. Many patients have allowed themselves to become deconditioned due to their pain. When we teach people about pacing exercise at the Multidisciplinary Pain Clinic, we recommend that exercise should start at half the maximum amount of exercise that can be tolerated and then gradually increasing one’s activity level every few days. An intense exercise session that leaves you on the couch for several days is of no help. It may be worthwhile dividing your exercise into several brief sessions every day. Walking is the best exercise. Swimming or aquacize can be useful. Exercise should not be limited to the painful area of the body.
Stretching can be done by itself or in conjunction with an exercise program. There are many good books on stretching available. We have a sheet of stretches available at the Multidisciplinary Pain Clinic and posted on our website. Stretching should be done several times a day for short periods of time.
It is a good idea to stretch before your exercise session.
Therapies such as yoga or Tai Chi may be appropriate.
The GET SET program offered at the Edmonton General Hospital and the Gerald Zetter Centre is useful in MFPS.
Many MFPS sufferers complain of problems sleeping, so it makes sense to try to improve your sleep. The Multidisciplinary Pain Clinic has a handout available on proper sleep hygiene which is also posted on our website.
You can be taught relaxation and coping skills that you will be able to use on a daily basis
You may benefit from a formal pain management group such as the Life Despite Pain program at the Multidisciplinary Pain Clinic or other similar programs.
Trigger point injections
Trigger point injections are can be useful in MFPS. In trigger point injections, dilute local anesthetic in injected into your trigger points. These should be combined with stretching or massage. Steroids are usually not injected. Many patients get 3-4 weeks relief with trigger point injection with some cumulative benefit. In certain circumstances injection of Botulinum toxin may produce prolonged relief.
Trigger point injection is generally safe. There may be a temporary exacerbation of your pain. There is a small risk of a punctured lung.
Despite little experimental evidence that acupuncture is effective in MFPS, many of our patients find it to be effective.
Intramuscular stimulation (IMS) which uses acupuncture needles may also be effective.