Improving characterization and diagnosis quality of myofascial pain syndrome: a systematic review of the clinical and biomarker overlap with delayed onset muscle soreness

Eur J Phys Rehabil Med. 2020 Aug;56(4):469-478. doi: 10.23736/S1973-9087.20.05820-7. Epub 2020 Feb 18.


Introduction: Myofascial pain syndrome (MPS) is one of the most common conditions of chronic musculoskeletal pain, yet its mechanisms are still poorly understood. Delayed Onset Muscle Soreness (DOMS) is also a regional pain syndrome that has clinical similarities to MPS, but has been better investigated. Emerging research suggests that DOMS may be a valid experimental model for studying MPS; however, a comparison of the similarities and differences of these two conditions has previously not been performed. Herein, we aimed to identify the similarities and differences in the clinical features and biomarkers between DOMS and MPS in order to better define MPS and identify future areas of (DOMS-informed) MPS research.

Evidence acquisition: In order to identify similarities and differences in the clinical manifestation and biomarkers of DOMS and MPS, scoping literature searches were performed using Medline (1965-2019), Embase (1966-2019) and Central (1966-2019) databases. Fifty-three full-text articles were reviewed out of the 2836 articles retrieved in the search.

Evidence synthesis: A scoping review of the literature demonstrated that DOMS and MPS similarly present as conditions of musculoskeletal pain that are associated with decreased strength and limited range of motion. However, while taut bands and discrete tender spots were described in DOMS, none of the studies reviewed have characterized whether these tender points represent the classic myofascial trigger point phenomenon observed in MPS. Certain systemic circulation biomarkers, including inflammatory cytokines and growth factors, were commonly elevated in MPS and DOMS; further research is needed to determine if other biomarkers that are currently characterized in DOMS are useful to enhance the clinical evaluation of MPS.

Conclusions: DOMS and MPS share clinical and biomarker similarities suggesting that DOMS may be a useful model for studying MPS.

Publication types

  • Comparative Study
  • Systematic Review

MeSH terms

  • Biomarkers / metabolism*
  • Humans
  • Myalgia / diagnosis*
  • Myalgia / metabolism*
  • Myalgia / physiopathology
  • Myofascial Pain Syndromes / diagnosis*
  • Myofascial Pain Syndromes / metabolism*
  • Myofascial Pain Syndromes / physiopathology


  • Biomarkers