Myofascial Pain Syndrome: Pathophysiology and Clinical Aspects

Abstract Background: Myofascial pain syndrome (MPS) is a highly prevalent yet frequently underdiagnosed musculoskeletal condition associated with significant functional impairment. Its clinical complexity and the absence of objective biomarkers contribute to diagnostic challenges. Aims: To review the epidemiology, pathophysiology, clinical presentation and therapeutic management of MPS, with particular emphasis on its relevance to Physical and Rehabilitation Medicine (PRM). Methods: A narrative review of key literature in PRM, rheumatology and pain medicine was conducted, focusing on trigger points, taut bands, nociception, and peripheral and central sensitisation mechanisms. Results: MPS is characterised by regional pain associated with myofascial trigger points within taut muscle bands. Peripheral mechanisms involve motor endplate dysfunction, local ischaemia and the release of algogenic substances, while sustained nociceptive input may induce central sensitisation. Diagnosis is clinical, based on physical examination findings. Management is multimodal and function-oriented, integrating pharmacological, interventional and rehabilitative strategies. Conclusion: MPS is a complex condition involving interconnected peripheral and central mechanisms. A biopsychosocial and rehabilitation-focused approach is essential for effective management. Further high-quality research is required to strengthen diagnostic criteria and therapeutic evidence.