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A Multimodal Approach to Treating Chronic Muscular Pain

Myofascial pain syndrome (MPS) is quite possibly one of the most prevalent, yet poorly defined pain syndromes in the general population. Nearly all of us will experience muscular pain at some time or another due to direct muscle trauma, injury, overuse, or an acute strain. Typically the pain will resolve within a few weeks, however, resolution of this acute muscular pain is not always sufficient and in many cases, pain may become chronic in nature.

Taking A Multimodal Approach

This is a topic that’s near and dear to my heart because, although I’ve always believed that a multimodal approach is the only way to effectively treat pain, this truth has become more evident than ever as the COVID-19 pandemic has significantly impacted the way we practice medicine.

A multimodal approach to the treatment of pain is just a fancy way of saying that the treatment plan includes therapies from multiple different modalities. The big categories I like to think about are: (1) procedures, (2) medications, (3) psychosocial treatments, and (4) lifestyle changes like diet, exercise, mindset and sleep.


While procedures can offer temporary pain relief, they are just that, temporary. There are times when the pain relief is prolonged, but these instances are rare and generally unpredictable. Therefore, the primary therapeutic benefit of procedures, especially in young individuals, is to reduce pain enough to allow participation in physical therapy and strengthening exercises.


Medications are an important treatment modality in pain management as well, but rarely reduce pain 100% and have significant side effects including, but definitely not limited to, sedation, GI upset or bleeding, respiratory depression, and even addiction. While over the counter and prescription medications may be helpful, I like to think of them as temporary as well; to be used until lifestyle changes can take effect.

Psychosocial Interventions

With less potential side effects, psychosocial and/or behavioral medicine interventions like cognitive behavioral therapy and biofeedback can provide significant benefit, but often are expensive and are usually administered under the direction of a trained provider. Therefore, these treatment options may be limited by time and/or financial resources.

Lifestyle Changes

This brings us to LIFESTYLE and the range of benefits that come from making healthy choices in your life. Importantly, diet, exercise, mindset and sleep can offer powerful, effective, and lasting pain relief…and of course, other health benefits too.

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