Fibromyalgia and Myofascial Pain Syndrome are separate disorders that share a number of common features. Individuals who suffer from one are much more likely to suffer from the other, suggesting a common underlying pathology.
Fibromyalgia and myofascial pain syndrome are often confused with one another. While they share a number of symptoms in common, they are not the same disease and have some dramatic differences. In both cases, the causes of the disorder are unknown. It is not uncommon for individuals to suffer from both disorders at the same time.
While fibromyalgia and chronic fatigue syndrome are often referred to as “myofascial pain syndromes,” this does not imply that they are the same as myofascial pain syndrome. Unfortunately, medical terminology has created a great deal of confusion in this area. The term myofascial simply refers to the muscles and tendons. Because fibromyalgia and chronic fatigue syndrome primarily affect the muscles and tendons, they are sometimes categorized as myofascial pain syndromes. This designation is not the same as the condition described below that is officially termed myofascial pain syndrome. To set the two terms apart, myofascial pain syndrome is sometimes called chronic myofascial pain (CMP).
Fibromyalgia, sometimes called fibromyalgia syndrome, is chronic pain disorder characterized by diffuse aches and pains throughout the body. It can be associated with irritable bowel syndrome, fatigue, sleep disturbance, and cognitive deficits often referred to as “fibro fog.” Fibro fog manifests as confusion and difficulty concentrating and is not permanent.
Myofascial Pain Syndrome (MPS)
Unlike fibromyalgia, which is characterized by diffuse aches and pains, MPS is characterized by distinct pain in isolated areas of the body and localized symptoms caused by “trigger points.” The pain is steady and deep and ranges from mild discomfort to “lighting-like” pain that suffers describe as “excruciating.” It is characteristic that MPS pain does not resolve on its own and requires trigger point release techniques like injections or massage that provide only temporary relief.
There are several risk factors for developing MPS including stress, anxiety, inactivity, muscle injury, age (middle age onset is most common) and gender. Like fibromyalgia, women are far more likely to experience MPS than are men.
Myofascial pain syndrome is diagnosed by the presence of two types of trigger point. An active trigger point is one that is extremely tender, lies within a skeletal muscle, and is associated with local or regional pain. A latent trigger point is a hard knot in a muscle that is not tender, but which could become active and create pain. Secondary trigger points can also aid in the diagnosis. These are trigger points that are only palpable when a muscle is overloaded by pulling on it or making it do work. These trigger points cause pain, but may be missed on a passive exam.
Fibromyalgia and Myofascial Pain Syndrome
Despite their differences and the understanding that they are unique disorders, fibromyalgia and myofascial pain syndrome share a number of things in common. First and foremost the disorders can occur together in a number of individuals. There are no exact statistics on these two disorders and their co-occurrence, but some experts in the field have suggested that MPS can turn in to or cause fibromyalgia. Many people who suffer from both fibromyalgia and myofascial pain syndrome find that MPS is most common in their necks and shoulders. Trigger point injections are exceptionally helpful for these individuals.
Fatigue is a serious problem in both fibromyalgia and myofascial pain syndrome. It is also thought that chronic fatigue syndrome may affect up to two thirds of patients suffering from each disease. The fatigue is separate from, though linked to, the disturbed sleep that is common to both syndromes.
Another common link between fibromyalgia and myofascial pain syndrome is treatment. Both disorders tend to respond to similar types of treatments, which suggests they have similar, though not identical underlying causes. SSRIs and other antidepressants are effective in reducing the frequency and severity of symptoms in both disorders. Drugs like Lyrica, gabapentin and muscle relaxants are also effective. Trigger point injections can be effective in both, though they have much more pronounced effects in MPS. Massage is also effective in both conditions.
Sleep is a common link between fibromyalgia and myofascial pain syndrome. In both conditions, disorder sleep is thought to be a primary driver of symptoms. While it is not thought that disturbed sleep is to blame for either condition, it is the general consensus among the medical community that correcting disordered sleep can go a long way to improving symptoms. People suffering from either or both are encouraged to obtain adequate rest and practice good sleep hygiene.
Exercise is also a shared treatment between fibromyalgia and myofascial pain syndrome. In either case, mild aerobic exercise and yoga have been show to dramatically decrease symptoms in both conditions. Also, inactivity is a known trigger for symptoms and is associated with worsening of both syndromes. People suffering from fibromyalgia and myofascial pain syndrome are encouraged to partake in a minimum of 15 minutes of light exercise every day to help reduce symptoms.
Symptoms and treatment of both fibromyalgia and myofascial pain syndrome are very similar. Patients suffering from one are very like to suffer from the other as well. While not the same disorder, fibromyalgia and myofascial pain syndrome share a number of common factors.