Myofacasical Pain Syndrome / Fibromyalgia. Interesting article.

Discussion in 'Fibromyalgia Main Forum' started by kjfms, Jul 26, 2008.

  1. kjfms

    kjfms Member

    Myofacasical Pain Syndrome vs. Fibromyalgia
    by Dr. Mark Borigini

    Monday, May 19, 2008

    Many patients are labeled with fibromyalgia simply because they have chronic soft tissue pain. But it is important, at least for the sake of correctness, that not all chronic soft tissue pain be called fibromyalgia.

    In fact, localized or regional pain is often due to myofascial pain syndrome (MPS), a rather common condition which affects certain muscle areas. MPS is often present in fibromyalgia patient, but not all MPS patients also suffer from fibromyalgia.

    MPS generally involves pain in the neck, shoulders, hips, back, jaw and head. This pain is often accompanied by stiffness or tightness. It is important that the doctor listen to the patient to learn where the pain is most intense. And because MPS is not diagnosed with a lab test or x-ray, it is important that the doctor carefully examine the patient.

    Trauma is a common cause of MPS, in the form of muscle strain or ligament and tendon sprain; or as a result of chronic trauma due to repetitive work injury, or altered posture due to poor exercise.

    An example of the former is whiplash from an auto accident. An example of the latter is an individual who works at a computer all day, and subsequently develops MPS involving the muscles of the upper back and shoulders; such individuals often develop tension headaches.

    Of course, more than one area may be involved, and this can make distinguishing between MPS and fibromyalgia all the more difficult.

    MPS can occur with a variety of medical problems, including spinal disc disease, or inflammatory illnesses. And like fibromyalgia, MPS symptoms can be made worse due to stress, depression, fatigue and vitamin deficiencies, to name a few.

    It is important for the doctor to identify all other illnesses in an individual patient so that therapy can be most effective and accurate.

    Just as there is no cure for fibromyalgia, there is no cure for MPS. The goals of treatment should obviously include pain relief and improvement/restoration of mobility and functionality.

    It is important to identify any other accompanying conditions, and give treatment to these as well.

    Perhaps most importantly, the patient needs to be educated on how to best manage chronic pain, so that life can be lived as normally as possible.

    Just because there is no cure for MPS, do not think there is no treatment.

    Treatments include physical therapy and stretching exercises, massage therapy, trigger point-injections, and medications such as anti-inflammatories, muscle relaxants, antidepressants, and anti-seizure drugs (for example, gabapentin).

    But I believe that education is the most important component of the treatment regimen.

    Patients must be taught and encouraged to perform home exercises.

    Patients must be vigilant about appropriate posture, and ensuring that their workplace has the best ergonomics. Patients also benefit greatly from practicing biofeedback techniques that assist in stress reduction, which in turn reduces the tension in the muscles and the pain a patient experiences.

    And while the treatment for MPS sounds quite similar to that given to our fibromyalgia friends, let us not forget the key differences between these two chronic pain conditions:

    MPS has more localized or regional pain versus the diffuse pain of fibromyalgia.

    MPS patients have "trigger points" which can cause pain at a distant location when pressed, whereas fibromyalgia patients suffer from "tender points."

    MPS has a better prognosis, as the pain often resolves with treatment or the rectification of the offending stimulus (such as the ergonomically incorrect office desk); the pain of fibromyalgia has a much higher chance of being chronic.

    Unfortunately, both MPS and fibromyalgia are frequently not diagnosed properly.

    This in turn leaves many with chronic pain that is not being treated properly.

    In a way, it may be less important whether a doctor gets MPS confused with fibromyalgia, or vice-versa.

    But what is important is that we have doctors who understand the importance and the necessity of giving those patients with widespread pain all the help available, just as those with regional pain deserve all the treatment available to ease their suffering.

    Chronic pain by definition is always there, but that does not mean it always must be there with the same intensity.

    Thanks for reading,

    Karen :)[This Message was Edited on 08/01/2008]
  2. gapsych

    gapsych New Member

    This article was very informative. Thanks for posting it.

  3. kjfms

    kjfms Member

    You are welcome.

    How are you doing?

    Karen :)
  4. mujuer

    mujuer New Member

    Great Post especially for the new people here. There is an awesome book about having both FM and CMP for the people here who might be interested. It is called "Fibromyalgia & Chronic Myofascial Pain" A Survivial Manual by Devin Starlanyl. I think this book goes hand in hand with "The Trigger Point Therapy Workbook" by Clair Davies. I bought both at the same time and they have helped me so much. Thanks for the Post kjfms. P
  5. layla1954

    layla1954 New Member

    I have both CMP and FM. The way I can tell which one is flaring is by the type/location of aches or pains. When myofascial trigger points are acting up it hurts like the devil but is more localized. Like right now I have some active TrPs in my intercostal muscles that make me want to cry and the satellite TrPs are starting to join in the fun, so my whole side hurts from shoulder to hip.

    When it's a fibro flare it's a generalized hit-by-a-truck aching from head to foot, general weakness, and exhaustion.

    Of the two I "prefer" (lol) the myofascial pain because it will respond to 800mg ibuprofen, heat, massage, and Soma and will usually get better in a couple of days. Nothing but NOTHING seems to help a fibro flare except going to bed.
  6. kjfms

    kjfms Member

    Hi mujuer/P,

    Thank you so much for the book title it sounds very interesting and I will look to the local library to see if they have a copy.

    I have heard of the Trigger Point Therapy for someone here quite a while back and have had the chance to read it(thanks for mentioning that one too).

    I am very happy that you have been helped with them. I have not been diagnosed with CMP but I do plan to bring this up with my doctor because I think I may possibly have it.

    Take care --Karen :)

    Hi layla1954,

    I am sorry that you have both CMP and FMS and sorry for your pain.

    I am wondering about CMP because I do have some more localized pain at times and I seem to have them that possible I wonder.

    Take care -- Karen :)

    I hope you both feel better soon.
  7. Ginner

    Ginner New Member

    thank you for this information
    i am keeping this for reference
  8. layla1954

    layla1954 New Member

    Hi Karen,
    In response to your question YES! You can definitely have both. Many if not most people with fm also have myofascial pain, they go hand in hand a lot. I had the myofascial knots for several years before the fm actually got bad.

    best reagards,
  9. Gingareeree

    Gingareeree New Member

    I was Dx with fibro(without the tenderpoints testing) based on the chronic pain I';ve had in neck/shldr. areas. I never really bought into that Dx because I don't have so many of the other symptoms related to fibro. Also, I begged to differ with my Dr. but he insisted that I had Fibro, wanted to send me to a rheumy. I've long thought that I most likely have myofascial syndrome. Thanks, this ariticle pretty much confirms that thought. Jeanne