rehabРеабилитологияJournal of Medical Rehabilitation2949-58732949-5881IRBIS LLC10.17749/2949-5873/rehabil.2026.68rehab-173Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESКомплексный подход при ведении пациентов с миофасциальным болевым синдромомMultimodal approach to managing patients with myofascial pain syndromehttps://orcid.org/0000-0002-2652-5169ХритининД. Ф.KhritininD. F.

Хритинин Дмитрий Федорович

ул. Трубецкая, д. 8, стр. 2, Москва 119048

Dmitry F. Khritinin

Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет им. И.М. Сеченова» Министерства здравоохранения Российской ФедерацииРоссияSechenov UniversityRussian Federation20261608202642146–157Copyright © Хритинин Д.Ф., 20262026Хритинин Д.Ф.Khritinin D.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rehabilitology.com/jour/article/view/173

Миофасциальный болевой синдром (МФБС) это широко распространенное расстройство, которое характеризуется локальной или иррадиирущей болью, возникающей из-за триггерных точек в мышцах и фасциях. Его лечение часто оказывается неправильным или отложенным, что приводит к снижению качества жизни пациентов. Причины заключаются в неполном понимании механизмов развития миофасциальной боли, отсутствии единых диагностических критериев и стандартных протоколов терапии. Целью данного обзора являлись обобщение, систематизация и оценка имеющихся данных об используемых в клинической практике методах лечения и реабилитации пациентов с МФБС. Анализ ряда систематических обзоров, метаанализов и отдельных исследований показал, что фармакологические методы включают пероральное применение нестероидных противовоспалительных препаратов, опиоидных анальгетиков, миорелаксантов, антидепрессантов, противоэпилептических препаратов, а также нанесение местных анестетиков в виде пластырей или кремов и инъекции в триггерные точки. К физическим методам относятся метод «сухой иглы», акупунктура, мануальная терапия, кинезиотерапия, ударно-волновая терапия, электромиостимуляция, магнитная стимуляция, фототерапия и ультразвуковая терапия. Средствами первой линии могут быть местные анестетики в сочетании с неинвазивными физическими методами. Терапия МФБС требует комплексного персонализированного подхода, а сохранение положительных результатов лечения и восстановление пациентов зависят от реабилитационных мероприятий, включающих физические упражнения, психологическую поддержку и соблюдение здорового образа жизни.

Myofascial pain syndrome (MPS) is a common disorder involving localized or referred pain that originates from trigger points in muscles and fascia. In many cases, its treatment is either inappropriate or delayed, leading to a reduced quality of life for patients. This is due to incomplete comprehension of the mechanisms underlying myofascial pain, the lack of uniform diagnostic criteria, and the absence of standard treatment protocols. This review aims to summarize, systematize, and evaluate the available data on treatment and rehabilitation methods used in clinical practice for patients with MPS. Numerous systematic reviews, meta-analyses, and individual studies were analyzed revealing that pharmacological methods include the oral administration of nonsteroidal anti-inflammatory drugs, opioid analgesics, muscle relaxants, antidepressants, and antiepileptic drugs. Topical anesthetics are also used in these approaches, either in the form of patches or creams; as well as injections into trigger points. Among the physical methods are dry needling, acupuncture, manual therapy, kinesiotherapy, shockwave therapy, electrical muscle stimulation, magnetic stimulation, phototherapy, and ultrasound therapy. As first-line therapy, topical anesthetics combined with non-invasive physical methods can be considered. MPS treatment requires a comprehensive and personalized approach. Positive treatment results and patient recovery depend on rehabilitation measures, particularly regular exercise, psychological support, and a healthy lifestyle.

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The authors declare that there are no conflicts of interest present.