Myofascial Pain Syndrome and Fibromyalgia

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Myofascial pain syndrome is a chronic pain disorder. Myofascial pain syndrome usually occurs after a muscle has been contracted over and over again. This can be caused by recurring motions used in jobs or hobbies or by stress-related muscle tension. In myofascial pain syndrome, pressure on sensitive points in your muscles (trigger points) causes pain in apparently not related parts of your body. This is called referred pain.

Causes

The cause of myofascial pain syndrome is unknown. Yet, previous injury, poor sleep patterns, hectic life situations, and depression are common fundamental conditions that may play a role in provocating and exacerbating myofascial pain syndrome. It is now felt that risk factors such as these may lead to a change in the capability of the brain to correctly process pain perception.

Sensitive areas of tight muscle fibers can form in your muscles after injuries or overdo. These sensitive areas are called trigger points. A trigger point in a muscle can cause damage and pain all over the muscle. When this pain persists and worsens, doctors call it myofascial pain syndrome.

Diagnosis of myofascial pain syndrome

 Physicians diagnose myofascial pain syndrome based on the areas of complaints of muscle pain and related tenderness during a physical examination. Broad laboratory testing is usually needless. There are no manifested changes (redness, warmth, inflammation, etc.) in areas of contribution. The manifestation is the same as similar areas on the other side of the body. The extensive, diffuse body participation that is characteristic of fibromyalgia is not present.

Fibromyalgia

Fibromyalgia is also known as chronic “widespread pain.” This type of pain is frequently felt in all four limbs and in the trunk. The American College of Rheumatology classifies chronic widespread pain as fibromyalgia if it is also accompanied by the definite existence of at least 11 out of 18 (pre-identified) tender points. These tender points are 1 centimeter areas in particular muscles which are very sensitive to the touch. Pain from tender points is local, that is, it goes no further than the tender point itself.

The muscles of fibromyalgia patients have been described by experts as “soft and doughy,” and there is extreme range of motion in the joints.

When comparing fibromyalgia patients to those with widespread pain but no tender points, research shows that the presence of the extra sensitive tender points is associated to greater pain, more severe symptoms and a more marked decrease in the quality of life. Fibromyalgia patients often complain of fatigue, sleep problems, headaches and mood turbulence.

Association between fibromyalgia and myofascial syndrome

Why people with MPS often develop FMS isn’t yet clear, but a growing body of confirmation shows that, in some people, chronic pain can make changes to the central nervous system, resulting in central sensitization. If theories are correct, early treatment of MPS may help to avoid FMS.

An rising umbrella term for FMS, MPS, and other conditions involving central sensitization is central sensitivity syndromes.

Common symptoms

Some symptoms associated with MPS are alike symptoms related with FMS. The symptoms they have in common include, disturbed sleep, memory troubles, soft-tissue pain ranging from mild to severe, aggravation of symptoms due to stress, changes in weather, and physical activity, mysterious sweating.

Symptoms specific to only fibromyalgia

Allergies and sensitivities, feeling weighed down due to high levels of sensory input, episodic confusion and puzzlement, panic attacks and exhaustion.

Symptoms specific to only myofascial syndrome

Mysterious nausea, popping or clicking joints, doubled or blurry vision, lack of feeling in the extremities, restricted range of motions in joints especially jaws.

Related Article:

Fascia: A Hidden Piece of Puzzle of the Fibromyalgia Pain

 

Difference between fibromyalgia and myofascial syndrome

As we have seen, fibromyalgia and myofascial pain syndrome are two very different problems. Fibromyalgia is a extensive pain syndrome accompanied by fatigue and muscle tenderness. These symptoms are not associated with inflammation. Treating fibromyalgia is often multidisciplinary, for example, you may need gentle to reasonable exercise, psychotherapy, and anti-depressants all at the same time. Myofascial pain, on the other hand, is the condition of muscles that occurs when trigger points cause reduced performance in soft tissue, and pain. Myofascial pain syndrome benefits from treatments that are physical in nature, such as physical medicine and healing movement aimed at improving postural alignment.

Research also supports the use of injections as a way to ease pain from trigger points. For people with tender points alone, however, treatment with injections has not shown to be very efficient. This is one notable difference between fibromyalgia and myofascial pain syndrome as published in medical literature. So, if you are considering injections for myofascial pain or for fibromyalgia, ask your doctor for more information.

Prognosis of myofascial pain syndrome

Myofascial pain syndrome can resolve with ideal treatment regimens. However, many patients with myofascial pain syndrome have symptoms for years. Outcomes are best when a comprehensive treatment approach is guided by a single doctor who is monitoring the response to a variety of therapies employed.

Home remedies for treating myofascial pain syndrome

Home remedies include exercise, massage, hot water soaks and resting.

Prevention

While myofascial pain syndrome cannot be prevented, it is certainly possible to keep away from factors that make the condition worse. This includes avoiding reinjure, minimize stress, maximize optimal sleep, and treat any underlying depression.

Complications

Sleep problems

Signs and symptoms of myofascial pain syndrome may make it difficult to sleep at night. You may have problem finding a comfortable sleep posture. And if you move at night, you might strike a trigger point and wake up.

Fibromyalgia

Some research suggests that Myofascial pain syndrome may expand to fibromyalgia in some people. Fibromyalgia is a chronic condition that features widespread pain. It’s believed that the brains of people with fibromyalgia become more sensitive to pain signals over time. Some doctors believe Myofascial pain syndrome may play a role in starting this process.

Related Article:

Treatment for Fibromyalgia using Myofascial Release

Reference:

  • Myofascial pain syndrome via Mayo Clinic
  • Myofascial Pain Sydrome vs Fibromyalgia By Anne Asher, CPT via VeryWell
  • Fibromyalgia & Myofascial Pain Syndrome By Adrienne Dellwo via VeryWell
  • Featured Image Courtesy SpineLive

Sources:

Clinical Biomechanics. 2008 Jun;23(5):623-9. Epub 2008 Feb 21. “Ability of magnetic resonance elastography to assess taut bands.”

Schmerz. 2003 Dec;17(6):419-24. “Diagnosis and therapy of myofascial trigger points.”

Schneider, R. Effectiveness of myofascial trigger point therapy in chronic back pain patients is considerably increased when combined with a new, integrated, low-frequency shock wave vibrotherapy (Cellconnect Impulse): A two-armed, measurement repeated, randomized, controlled pragmatic trial. J Back Musculoskelet Rehabil. Aug. 2017.

Simons, D., MD, Travell, J. MD, Simons, L., PT. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1 Upper Half of the Body. 2nd Edition. Williams & Wilkins A Waverly Company 1999. Baltimore.

Wolfe, F., et. al. 2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria American College of Rheumatology Meeting Abstracts. September 2016.

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