Myofascial Pain Syndrome and Fibromyalgia

What are Myofascial Pain Syndrome and Fibromyalgia

Myofascial pain syndrome and fibromyalgia are both pain disorders. This pain may be felt mainly in your muscles.

  • Myofascial pain syndrome:
    • Always has tender points in the muscle that will cause pain when pressed (trigger points). The pain may come and go.
    • Usually affects your neck, upper back, and shoulder areas. The pain often radiates into your arms and hands.
  • Fibromyalgia:
    • Has muscle pains and tenderness that come and go.
    • Is often associated with fatigue and sleep problems.
    • Has trigger points.
    • Tends to be long-lasting (chronic), but is not life-threatening.

Fibromyalgia and myofascial pain syndrome are not the same.

However, they often occur together. If you have both conditions, each can make the other worse. Both are common and can cause enough pain and fatigue to make day-to-day activities difficult. Both can be hard to diagnose because their symptoms are common in many other conditions.

Myofascial pain syndrome is defined as a regional pain syndrome characterized by the presence of trigger points and localized areas of deep muscle tenderness in a taut band of muscle.

The myofascial pain syndrome is a chronic, regional pain syndrome that involves muscle and soft tissues. It is characterized by trigger points and taut bands. Originally described by Travell and later elaborated on by Travell and Simons, myofascial pain syndrome occurs in most body areas, most commonly in the cervical and lumbar regions.

Pressure on a trigger point reproduces the pain. In comparison, fibromyalgia is a systemic pain disorder associated with tender points in all four quadrants of the body for at least 3 months’ duration, often with associated sleep disturbance, irritable bowel syndrome, and depression. In myofascial pain syndrome, these associated features are significantly less frequent.

What are the causes?

The exact causes of these conditions are not known.

What increases the risk?

You are more likely to develop this condition if:

  • You have a family history of the condition.
  • You have certain triggers, such as:
    • Spine disorders.
    • An injury (trauma) or other physical stressors.
    • Being under a lot of stress.
    • Medical conditions such as osteoarthritis, rheumatoid arthritis, or lupus.

What are the symptoms?

Fibromyalgia

The main symptom of fibromyalgia is widespread pain and tenderness in your muscles. Pain is sometimes described as stabbing, shooting, or burning.

You may also have:

  • Tingling or numbness.
  • Sleep problems and fatigue.
  • Problems with attention and concentration (fibro fog).

Other symptoms may include: 

  • Bowel and bladder problems.
  • Headaches.
  • Visual problems.
  • Problems with odors and noises.
  • Depression or mood changes.
  • Painful menstrual periods (dysmenorrhea).
  • Dry skin or eyes.

These symptoms can vary over time.

Myofascial pain syndrome

Symptoms of myofascial pain syndrome include:

  • Tight, ropy bands of muscle.
  • Uncomfortable sensations in muscle areas. These may include aching, cramping, burning, numbness, tingling, and weakness.
  • Difficulty moving certain parts of the body freely (poor range of motion).

How is this diagnosed?

This condition may be diagnosed by your symptoms and medical history. You will also have a physical exam. In general:

  • Fibromyalgia is diagnosed if you have pain, fatigue, and other symptoms for more than 3 months, and symptoms cannot be explained by another condition.
  • Myofascial pain syndrome is diagnosed if you have trigger points in your muscles, and those trigger points are tender and cause pain elsewhere in your body (referred pain).

How is this treated?

Treatment for these conditions depends on the type that you have.

  • For fibromyalgia:
    • Pain medicines, such as NSAIDs.
    • Medicines for treating depression.
    • Medicines for treating seizures.
    • Medicines that relax the muscles.
  • For myofascial pain:
    • Pain medicines, such as NSAIDs.
    • Cooling and stretching of muscles.
    • Trigger point injections.
    • Sound wave (ultrasound) treatments to stimulate muscles.

Treating these conditions often requires a team of health care providers. These may include:

  • Your primary care provider.
  • Physical therapist.
  • Complementary health care providers, such as massage therapists or acupuncturists.
  • Psychiatrist for cognitive behavioral therapy.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
    • Drink enough fluid to keep your urine pale yellow.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
    • Take an over-the-counter or prescription medicine for constipation.

Lifestyle

  • Exercise as directed by your health care provider or physical therapist.
  • Practice relaxation techniques to control your stress. You may want to try:
    • Biofeedback.
    • Visual imagery.
    • Hypnosis.
    • Muscle relaxation.
    • Yoga.
    • Meditation.
  • Maintain a healthy lifestyle. This includes eating a healthy diet and getting enough sleep.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

  • Talk to your health care provider about complementary treatments, such as acupuncture or massage.
  • Consider joining a support group with others who are diagnosed with this condition.
  • Do not do activities that stress or strain your muscles. This includes repetitive motions and heavy lifting.
  • Keep all follow-up visits as told by your health care provider. This is important.

Seek Additional Information

Contact a health care provider if:

  • You have new symptoms.
  • Your symptoms get worse or your pain is severe.
  • You have side effects from your medicines.
  • You have trouble sleeping.
  • Your condition is causing depression or anxiety.

Summary

  • Myofascial pain syndrome and fibromyalgia are pain disorders.
  • Myofascial pain syndrome has tender points in the muscle that will cause pain when pressed (trigger points). Fibromyalgia also has muscle pains and tenderness that come and go, but this condition is often associated with fatigue and sleep disturbances.
  • Fibromyalgia and myofascial pain syndrome are not the same but often occur together, causing pain and fatigue that make day-to-day activities difficult.
  • Treatment for fibromyalgia includes taking medicines to relax the muscles and medicines for pain, depression, or seizures. Treatment for myofascial pain syndrome includes taking medicines for pain, cooling and stretching of muscles, and injecting medicines into trigger points.
  • Follow your health care provider’s instructions for taking medicines and maintaining a healthy lifestyle.
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