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Pain and Spine Medicine

Session: Multidimensional analysis of the clinical spectrum and symptom burden of unexplained myofascial pain

Multidimensional Analysis of the Clinical Spectrum and Symptom Burden of Unexplained Myofascial Pain

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 10
Disclosure(s):
Naomi Lynn Gerber, MD: No financial relationships to disclose
John Srbely, PhD: No financial relationships to disclose
Secili DeStefano, PT: No financial relationships to disclose
Samuel Acuna, PhD: No financial relationships to disclose
Background and/or Objectives: Pain quality and severity vary widely for people with myofascial pain (MP), making it difficult to accurately select outcome measures. We assessed potential contributors to symptom variability of MP to define the clinical spectrum and symptom burden of unexplained neck/shoulder pain and classify MP.

Design: : Prospective Cross-sectional study.

Setting :: University research center.

Participants : Adults reporting neck/shoulder pain and pain-free individuals.

Interventions: N/A

Main Outcome Measures: Pain intensity and interference (PEG); pain catastrophizing (PCS); PROMIS physical function (PF); sleep disturbance; anxiety (GAD-2); depression (PHQ-2); hypermobility (Beighton/Brighton); pressure-pain threshold (PPT) and quantitative sensory testing (QST).

Results: Of 96 adults recruited for the study, 82 had complete records (age 32.2 +/-13.1 years, 57% women). Of these, 23 were clinically assessed and assigned to a spontaneously symptomatic group (SS; those with spontaneous MP without provocation), and 59 were in a currently asymptomatic group (CA; including those with pain upon provocation). PF and PCS are key predictors of PEG (p < 0.0001 and p = 0.0006, respectively). PCS is an important predictor in both SS (p < 0.02) and CA (p < 0.01) groups, while PF (p = 0.025) and PHQ-2 (p = 0.04) are important in the CA group. Selected variables explained 74% of the variance in PEG in the overall sample, and 85% in the SS group. In the SS group, PF shows negative correlations with hypermobility (-0.43) and PEG (-0.37), while PCS is positively linked to PEG (0.38) and GAD-2 (0.36). In the CA group, PHQ-2 is positively correlated with GAD-2 (0.47), and PPT is negatively correlated with QST (-0.30). These measures differentiated between the SS and CA groups with 87% accuracy (92% sensitivity, 74% specificity).

Conclusions: Selected patient-reported outcomes and objective measures explain the clinical spectrum of symptoms of unexplained neck/shoulder pain and successfully classify these clinically-relevant subgroups with MP.