Experts in physical medicine and rehabilitation are sounding the alarm about one of the most common causes of sick leave and loss of quality of life among the active population: recurrent back pain. Although workers commonly link cervical or lumbar discomfort to disc herniations or cartilage wear, clinical evidence indicates that, in the vast majority of cases, the origin is muscular.
The so-called Myofascial Pain Syndrome (MPS) is triggered by the presence of trigger points — hyperirritable zones within a tight band of muscle — that limit mobility and cause constant discomfort in people who spend long hours in front of screens.
The diagnostic challenge: referred pain vs structural injury
One of the main difficulties in resolving this condition is the phenomenon of referred pain. Localized tension in a specific muscle point often radiates to other regions of the body, mimicking more serious pathologies.
“The place where we feel the pain does not always coincide with its origin. A trigger point is a particularly sensitive area of muscle that can reproduce local pain and also project it to other regions. For example, muscle-origin pain in the gluteal area can extend down the leg and be mistaken for sciatica,” explains Dr. Miguel Bernardo Salmerón Celi, a physician specializing in Physical Medicine and Rehabilitation at the Prince of Asturias University Hospital in Madrid.
The specialist adds that the presence of anatomical findings on imaging tests does not always justify the patient’s pain: “Finding a herniation on an MRI does not automatically explain all the symptoms. As a rehabilitation physician, the key is to relate what the patient reports with the muscular and neurological examination: check strength, sensation, reflexes, and which maneuvers reproduce their usual pain.”
Beyond medications: the need for a comprehensive approach
Prolonged use of analgesics or the application of superficial massages tends to offer only temporary relief, as they do not modify the biomechanical factors that perpetuate the injury. If we do not act on the muscle’s capacity or on postural habits, deep inflammation tends to flare up again after a short time.
“Analgesics can relieve symptoms and manual therapy can improve pain and mobility, but we need to accompany them with progressive exercise, load adaptation, and changes in habits that perpetuate the problem. The goal is lasting improvement and recovery of function,” explains Dr. Salmerón Celi.
For those cases of persistent myofascial pain where the aim is to avoid invasive needle or injection techniques, physical medicine has incorporated biomodulation technologies using acoustic energy. Focused shockwave therapy allows applying highly precise mechanical stimuli to the exact depth of the contraction, promoting tissue relaxation and reactivation of blood flow.
“The appeal of focused shock waves lies in their ability to concentrate a mechanical stimulus in a selected area and adjust the depth and energy to the tissue we want to treat. This offers a non-invasive option for certain patients with myofascial pain, especially when we seek an alternative to needle-based techniques. With equipment like STORZ Medical we can administer this treatment by adjusting its parameters according to the diagnosis. Its greatest usefulness is to help the patient move better and progress in an active rehabilitation program,” emphasizes the specialist.
Active prevention: breaking immobility in the workplace
Beyond in-clinic treatments, experts remind us that the best tool against muscular chronicity is postural variability and regular physical activity. Staying still for hours subjects the tissue to an inappropriate static load, regardless of how ergonomic the chair is.
“The first recommendation is to vary your posture. There is no perfect position we should maintain throughout the day: even a comfortable posture can become uncomfortable if we stay still for too long. As a practical guideline, I recommend standing up and walking for a few minutes every 30 minutes or every hour. The message is simple: change position, move frequently, and progressively improve muscular capacity,” concludes Dr. Miguel Bernardo Salmerón Celi.
