Chronic neck and shoulder pain. Focusing on myofascial origins.

Chronic neck and shoulder pain is a complex, multifactorial problem. Often many months have passed since its onset. During this time the patient may have seen many physicians and tried many medications, some with abuse potential. Most patients are depressed and have lost their ability to cope with the stresses of daily life. The goals of therapy are to enable patients to deal with the problem and to bring them to the point where pain is no longer the dominant factor in their lives. For patients with chronic neck and shoulder pain of myofascial origin, this is accomplished with a multi-disciplinary approach that incorporates use of psychotherapeutic techniques, nonsteroidal antiinflammatory medications, antidepressant drugs, trigger-point injection, and several physical therapy modalities.