Myofascial pain syndromes and their effect on the lower extremities.

Myofascial pain syndrome is an entity with which every podiatrist should be familiar. These disorders are usually the result of acute or chronic injury and are characterized by the presence of trigger areas and symptom complexes that have definite patterns. Once these patterns have been learned, the sources of pain can be readily predicted. Most of these conditions can be effectively treated in the podiatrist's office by local block techniques and/Or by application of Fluori-Methane spray. It is important to consult the appropriate medical specialist for diagnostic confirmation or for aid in treatment if uncertainty exists. Treatment regimens in this group of syndromes are based on the notion that in these disorders there is a self-sustaining cycle of pain-spasm-pain persisting after the precipitating cause has disappeared, which may be permanently abolished by interruption of the reflex mechanisms. In order to produce optimal results, the trigger area must be accurately located and treatment directed toward its elimination. Physical therapy and active exercise are necessary adjuncts to local blocks. Not all patients respond, and in many the response is slow, incomplete, and/or only temporary, but there are those in whom these simple measures provide relief of pain and disability in a manner as dramatic as one is likely to encounter in practice.