Fibromyalgia and myofascial pain syndrome often go hand in hand. Due to their frequent overlap and some similar symptoms, they are often mistaken for the same condition, and as a result, sufferers are sometimes diagnosed and treated for only one.
This is a real problem, for three main reasons:
- which require different treatment
- MPS trigger points can be removed
- MPS can exacerbate FMS pain, and reducing MPS pain can significantly relieve FMS symptoms.
Some researchers use the name “chronic myofascial pain” (CMP) instead of myofascial pain syndrome because it has been shown to be a disease, not a syndrome. (A “syndrome” is a collection of symptoms with no known cause.)
Overview
In MPS, the muscles and connective tissues (which make up fascia) develop what is called a trigger point (TRP). These are not the same as FMS tender points.
A trigger point is a small, hard knot that can sometimes be felt under the skin. The knot itself can be painful, especially when pricked, but it often causes pain in another area, called referred pain.
Trigger points typically form as a result of tissue trauma. Experts don’t know what damage normal healing in most people causes to the HPs of others. However, studies suggest that muscle injuries in some people lead to abnormalities in the nerve cells connected to muscle cells. This suggests that MPS is a neuromuscular disorder.
Association
The reason why people with MPS frequently develop fibromyalgia syndrome remains unclear, but growing evidence shows that, in some people, chronic pain can alter the central nervous system, leading to central sensitization. If the theories are correct, early treatment of MPS may help prevent fibromyalgia syndrome.
An emerging umbrella term for FMS, MPS, and other central sensitization-related diseases is central sensitivity syndromes.
The symptoms
Some of the symptoms associated with MPS are similar to those associated with FMS, while others are related to only one of them.
Symptoms they have in common include:
- soft tissue pain ranging from mild to severe
- headaches and/or migraines
- sleep problems
- balance problems and/or dizziness
- tinnitus (ringing in the ears) and ear pain
- memory problems
- unexplained sweating
- worsening of symptoms due to stress, weather changes/extremes, and physical activity
Symptoms associated with MPS, but not FMS, include:
- numbness of the extremities
- joints that click or burst
- limited range of motion in joints, especially the jaw
- double or blurred vision
- unexplained nausea
Symptoms associated with FM, but not MPS, include:
- fatigue
- panic attacks
- feel overwhelmed due to high levels of sensory information
- allergies and sensitivities
- periodic confusion and disorientation
For more fibromyalgia symptoms, check out Monster’s List of Fibromyalgia Symptoms.
Diagnosis
Referred pain makes MPS particularly difficult to diagnose and treat. The doctor typically says, “Where does it hurt?” And then look where you’re aiming. To treat MPS, you and your doctor need to examine your symptoms and find out where your trigger points are.
Your doctor may find trigger points by touch or based on symptoms.
Tests such as magnetic resonance elastography and tissue biopsy can show PG abnormalities, but their role in diagnosing MPS is not yet clear.
In contrast, no test or scan reveals abnormalities in the tissues felt by people suffering from fibromyalgia syndrome pain.
offers
You have several options for treating MPS:
- Trigger point injections: The doctor inserts a needle directly into a PRO or various points around it to loosen tight bands. The doctor may inject a pain reliever, such as corticosteroids or lidocaine. (Note: Some doctors believe corticosteroids can exacerbate fibromyalgia symptoms.) When medication is not used, it is called dry needling.
- Acupuncture: Acupuncture is an ancient Chinese practice similar to dry needling. Although studies on its use in MPS are limited, they are promising, and many patients and professionals report good results.
- Physical therapy: A special type of therapy called spray and stretch is common for treating MPS. A physical therapist guides you through stretching exercises while a numbing substance is sprayed onto your muscle. The therapist may also use certain massage techniques to relax the muscles and PG. Additionally, a therapist can work with you on factors such as poor posture that may contribute to MPS.
- Medications: Common medications for MPS include nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aleve (naproxen) or ibuprofen medications such as Advil and Motrin, as well as tricyclic antidepressants such as amitriptyline, doxepin, and nortriptyline.
Treatments MPS vs. FMS Treatments
Again, there are some overlaps, but also important differences. Treatments used for MPS and FMS include:
- acupuncture
- physiotherapy (although in different forms)
- Tricyclic antidepressants (although SSRI/SNRI antidepressants are increasingly common in FMS)
Studies show that trigger point injections are not effective in relieving fibromyalgia tender points and that NSAIDs are not effective in treating the pain of fibromyalgia syndrome.
For more information on fibromyalgia treatments, see Fibromyalgia Treatment – A Multidisciplinary Approach.
Albardille
With significant differences in their symptoms, diagnosis, and treatment, it’s clear that fibromyalgia and myofascial pain syndrome are not the same condition. However, it can be extremely difficult to determine which condition is causing pain when a person suffers from both.
By working alone and with your doctor and/or physical therapist, you may be able to determine where you have trigger points and the best way to treat them without exacerbating your fibromyalgia. Relieving myofascial pain is likely to calm fibromyalgia symptoms, so you may see a double benefit.
