Myofascial Pain Syndrome (MPS) Treatment in Kathmandu: Trigger Points, Causes and Manual Therapy
Myofascial Pain Syndrome (MPS) Treatment in Kathmandu: Trigger Points, Causes and Manual Therapy
Myofascial pain syndrome (MPS) is one of the most common — yet most frequently misdiagnosed — causes of chronic musculoskeletal pain in Nepal. Many patients with MPS spend months or years undergoing investigations and treatments for other conditions, remaining undiagnosed and in pain, simply because their trigger points have not been identified and treated.
At Manual Therapy Hospital — Nepal’s pioneer in manual therapy since 2011 — MPS and trigger point therapy is one of our core specialities. Our Baneshwor and Dhobighat clinics have treated hundreds of patients with chronic myofascial pain who had not found lasting relief elsewhere.
A trigger point is not just a ‘tight muscle’. It is a hypersensitive, dysfunctional area within a muscle that causes local pain, referred pain to distant areas, autonomic symptoms, and restricted movement. Understanding trigger points is the key to solving many cases of unexplained chronic pain.
What Is Myofascial Pain Syndrome?
Myofascial pain syndrome is a chronic pain condition characterised by the presence of myofascial trigger points — discrete, hypersensitive nodules within a taut band of skeletal muscle. When pressed, these trigger points reproduce the patient’s familiar pattern of pain — both locally and in predictable referred patterns distant from the trigger point itself.
For example, a trigger point in the upper trapezius muscle (upper back and neck) commonly refers pain to the temple and behind the eye — causing what appears to be a tension headache. A trigger point in the gluteus medius refers pain down the outer thigh, mimicking sciatica. Understanding these referral patterns is essential for accurate diagnosis.
What Causes Myofascial Trigger Points?
- Acute muscle overload — a sudden strenuous activity that the muscle is not conditioned for
- Repetitive strain — sustained low-level muscle activity over hours (desk work, manual labour)
- Poor posture — sustained awkward positions create persistent muscle loading
- Muscle injury — after a tear or strain, trigger points frequently develop in the healing tissue
- Physical deconditioning — weak, poorly conditioned muscles are more susceptible to trigger point development
- Psychological stress — emotional tension creates chronic muscle guarding, particularly in the neck and upper back
- Nutritional deficiencies — vitamin D, B12, and iron deficiency can perpetuate trigger point activity
Common Myofascial Pain Patterns We Treat in Kathmandu
| Trigger Point Location | Common Referred Pain Pattern |
| Upper trapezius (neck/shoulder) | Temple headache, back of head, outer eye area |
| Suboccipital muscles (base of skull) | Headache across the top of the head |
| Sternocleidomastoid (side of neck) | Front of head headache, ear pain, eye pain |
| Quadratus lumborum (lower back) | Hip, buttock, outer thigh pain |
| Gluteus medius (buttock) | Outer hip, outer thigh — mimics sciatica |
| Piriformis (deep buttock) | Buttock pain, posterior thigh — mimics true sciatica |
| Infraspinatus (shoulder blade) | Front of shoulder, upper arm, outer elbow pain |
| Iliopsoas (hip flexor) | Low back, groin, and anterior thigh pain |
Myofascial Pain Syndrome vs. Fibromyalgia: Key Differences
| Factor | Myofascial Pain Syndrome |
| Cause | Localised trigger points in specific muscles |
| Pain pattern | Regional — follows trigger point referral patterns |
| Tender points | Active trigger points with referred pain |
| Response to treatment | Responds well to trigger point therapy (needling, manual therapy) |
| Associated symptoms | Primarily musculoskeletal |
How We Treat Myofascial Pain at Manual Therapy Hospital, Kathmandu
Dry Needling
Dry needling directly into active trigger points is the most specific and effective technique for trigger point deactivation. The needle produces a local twitch response — the involuntary muscle contraction that signals trigger point release — providing rapid pain relief and restoration of normal muscle function.
Ischaemic Compression
Sustained manual pressure applied to the trigger point until the pain releases. Effective for superficial trigger points and patients with needle sensitivity.
Myofascial Release
Sustained, gentle pressure along the direction of muscle fibres and fascial planes to release widespread fascial tension that perpetuates trigger point activity.
Cupping Therapy
Negative pressure cupping over myofascial regions creates tissue lift and fascial decompression that complements trigger point therapy by improving circulation and reducing fascial adherence.
Corrective Exercises and Perpetuating Factor Management
Trigger points will return unless perpetuating factors are addressed. We provide comprehensive advice on posture correction, ergonomics, stretching, and strengthening exercises to maintain trigger point deactivation and prevent recurrence.
Frequently Asked Questions — MPS Treatment in Kathmandu
| Question | Answer |
| How do I know if I have myofascial pain syndrome? | The hallmark signs are: localised areas of muscle tightness that are exquisitely tender to firm pressure; pain that radiates from those tender areas in a predictable pattern; and the fact that pressing the tender area reproduces your familiar pain. A clinical assessment at Manual Therapy Hospital will confirm the diagnosis. |
| Is MPS the same as fibromyalgia? | No — they are different conditions, though they can co-exist. MPS has localised trigger points with specific referral patterns. Fibromyalgia involves widespread pain and central sensitisation. See the comparison table above for more detail. |
| How many sessions does MPS treatment take? | Active trigger points often respond within 3-6 dry needling sessions combined with manual therapy. Chronic, long-standing MPS with multiple trigger points may require 10-20 sessions. A home exercise programme is essential to maintain results. |
| Will my MPS come back after treatment? | It can, particularly if the perpetuating factors (posture, ergonomics, muscle conditioning) are not addressed. We provide comprehensive guidance on preventing recurrence as part of every treatment programme. |
| Is dry needling painful for trigger point treatment? | Triggering the local twitch response produces a brief, intense ache that most patients describe as unusual but therapeutic. The discomfort is brief and followed by a deep sense of muscle release. Post-needling soreness is normal for 24-48 hours. |
Book Your MPS Assessment at Manual Therapy Hospital, Kathmandu
Baneshwor: 9863336363 | 01-4622033 (Min Bhawan New Baneshwor)
Dhobighat, Lalitpur: 9841200805 | 01-5188067
Open: Sunday-Friday: 7:00 AM – 6:00 PM
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