Focused review: myofascial pain.

Myofascial pain is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of myofascial pain is an important part of musculoskeletal rehabilitation of regional axial and limb pain syndromes. This article reviews the current hypotheses regarding the pathophysiology of myofascial trigger points and muscle pain. A critical evidence-based review of the pharmacologic, nonpharmacologic, alternative medicine, and exercise treatments of myofascial pain is provided, as well as future research directions. OVERALL LEARNING OBJECTIVE: To review critically the state of the art knowledge of myofascial pain, including pathophysiology and comprehensive management. Areas of future research are identified.