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Myofascial Pain Syndrome, or MPS is a chronic condition that affects the fascia (connective tissue that covers the muscles). The syndrome may involve either a single muscle or a muscle group. In some cases, the area where a person experiences the pain may not be where the myofascial pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This situation is known as referred pain.
Ask the average medical student to name all the pain systems of the body and he will likely mention the somatic pain apparatus carried via the spinothalamic tracts and the sensory division of the autonomic nervous system. He may not be sure if there are one or two spinothalamic tracts (anterior and lateral), but even if he mentions the dual tracts, he may have difficulty remembering which pain is carried in which division.

The one pain system which nearly all forget is the sensory arm of the gamma motor system, or pain sensation from the muscle spindle apparatus. Even if a physician encountered a patient with nociceptive muscle spindle pain, he might not recognize it. This goes double for neuropathic pain from the spindle.

To the physician, muscle spindle pain isn't a problem and so he often forgets it exists. It is a big problem for many Central Pain patients. Patients with intact motor units who are functionally paralyzed are occasionally seen, and short of full paralysis there are many who suffer with any movement. Neuropathic gamma pain represents one of the clearest opportunities to really study the muscle spindle and learn how to identify its dysfunction clinically. Unfortunately, because it is so little studied, and so easily forgotten, almost no one with Central Pain is asked about motor pain, although muscle pain is a very definite Goliath which the patient must confront.

The muscle spindle is a marvel of servo control. Perhaps one in every two hundred muscle fibers has embedded a swollen bulb that informs the brain of the state of the muscle. For Nature's purposes, the muscle spindle also has a very effective pain sensing apparatus. The pain characteristics in Central Pain suggests the spindle is not shortchanged in the pain sensors which are supplied. It is fairly complex since it gives off both allodynic and hyperpathic pain, just as the skin does.

Deep pressure which stretches the spindle relieves the pain of "confinement cramps" (pseudocramp), but it does not relieve the dysesthetic allodynia which occurs with muscle loading. A very effective test for gamma pain is to ask the patient to go down into a squat position. This causes a dysesthetic burning "cramp" in the thigh, which accompanies a very definite sensation of "pulling" or "load on the muscle". It becomes unbearable in seconds to minutes. Many patients complain of great soreness when trying to lay in a bed and awaken feeling as if they had been beaten. This pain is not dysesthetic, but probably represents hyperpathic response to pressure, such as one might feel sitting on a chair for a very long time.