MYOFASCIAL PAIN SYNDROME VS FIBROMYALGIA, KNOW THE DIFFERENCE

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Myofascial pain syndrome (MPS) is another medical condition which often co-exist with Fibromyalgia. Again, the overlapping conditions show similar symptoms and can be confused as one. It is not uncommon for medical professionals to only identify only one of the syndromes when patients actually suffer from both. As a result, people who suffer from both Fibromyalgia and MPS are often only treated for only one of their conditions with the pain caused by the other still lingering in them.

Identifying MPS in fibromyalgia patients is important because MPS can intensify fibromyalgia pain, hence, alleviating MPS symptoms can help ease fibromyalgia. Unlike tender points in fibromyalgia, the characteristic trigger points in MPS can be treated.

What is Myofascial Pain Syndrome?

Myofascial pain syndrome, also known as chronic myofascial pain, is a musculosketal pain condition characterized by trigger points (trigger points in MPS should not be confused with tender points in fibromyalgia) which are painful abnormal points in the muscles tissues. Trigger points feels like a small knot under your skin and can be painful when pressure is applied or cause pain in unrelated areas (this is known as referred pain).

Trigger points usually form after some kind of muscle trauma where muscle tissues are damaged. Studies suggest that the injured muscle tissues of MPS patients heals abnormally where nerve cells connect to muscle cells forming trigger points. This points to MPS being a neuromuscular disease.

Why Do Fibromyalgia & MPS often co-exist?

Similar to fibromyalgia, MPS is a condition causing pain in the musculoskeletal system. However, in the case of MPS, the pain is localized unlike fibromyalgia where pain is believe to be centralized. It remains unclear why people with MPS tend to develop fibromyalgia later on but various studies have suggested that chronic pain conditions, not limited to MPS, can alter the behaviour of the brain and central nervous system causing increased central sensitivity. Hence it is believed that early treatment of MPS, or other chronic pain, can reduce risk of developing fibromyalgia.

MPS vs Fibromyalgia: Diagnosis

In comparison to fibromyalgia, the diagnosis of MPS is much easier with the help of medical tools such as magnetic resonance elastography and tissue biopsy which help reveal abnormalities in muscle tissues. A medical professional can also locate and examine the trigger points by feeling for it and observing your response although referred pain can sometimes complicate the diagnosis of MPS. Whereas in fibromyalgia, there are no medical technology to help with the location of tenderpoints.

MPS vs Fibromyalgia: Symptoms

MPS and fibromyalgia are often mistaken due to having similar symptoms. However, the two pain conditions also show distinct symptoms which help to differentiate one from the other. See comparison of MPS and fibromyalgia symptoms in the table below:

Myofascial Pain Syndrome Fibromyalgia

Muscle pain ranging from mild to severe
Headaches and/or migraines
Nonrestorative sleep
Balance problems and/or dizziness
Tinnitus (ringing in the ears) & ear pain
Poor memory
Unexplained sweating
Worsening symptoms due to stress, changes/extremes in weather, and physical activity

Peripheral numbness
Popping or clicking joints
Limited range of motion in joints and jaws
Blurry vision
Unexplained Nausea
Fatigue
Panic attacks
Light and noise sensitivity
Allergies
Occasional confusion & disorientation

MPS vs Fibromyalgia: Treatments

The treatment of MPS differs from fibromyalgia although there are some similarities. Treating MPS can help to reduce fibromyalgia symptoms and pain. However, some MPS treatment may worsen fibromyalgia. See comparison of MPS and fibromyalgia treatments in the table below:

Treatments Myofascial Pain Syndrome Fibromyalgia
Acupuncture Acupuncture is a technique often used in traditional Chinese medicine (TCM) involving the insertion of heated or electric stimulated needles into acupoints to relief pain. Studies showed positive results in treating both MPS and fibromyalgia.
Trigger point Injection A needle is inserted directly into a trigger point or in several places around it to loosen up the knot. When no medication is used, the technique is called dry needling similar to acupuncture. Pain-relieving medication, such as corticosteroids or lidocaine can be injected sometimes. Trigger-point injections has no positive effect on fibromyalgia tender points although it is still effective in relieving trigger points in fibromyalgia patients. However, some doctors believe that injection of corticosteroids to treat trigger points can worsen fibromyalgia symptoms
Physical therapy Spray-and-stretch therapy involves going through a series of stretching exercise with a physical therapist. The therapist will apply a numbing spray on your muscles when necessary Fibromyalgia
Massage Massage technique helps loosen muscles and trigger points Massage only help to provide temporary pain relief, stress relief and induce relaxation but has no effect on tender points
Medications Nonsteroidal anti-inflammatory drugs (NSAIDs) NSAIDs are not effective for fibromyalgia because they provide pain relief caused by inflammation, and studies have shown that fibromyalgia is not an inflammatory condition.
Tricyclic antidepressants Tricyclic antidepressants are also administered although SSRI/SNRI antidepressants are becoming more popular

Treating myofascial pain is likely to help you reduce your fibromyalgia symptom. Work with your healthcare provider to locate your trigger points and discuss the best treatment choice without aggravating your fibromyalgia. Treating myofascial pain is likely to help you reduce your fibromyalgia symptom. Work with your healthcare provider to locate your trigger points and discuss the best treatment choice without aggravating your fibromyalgia.

Sources:

  1. Chandola H C and Chakraborty A. Fibromyalgia and Myofascial Pain Syndrome-A Dilemma. Indian J Anaesth. 2009 Oct; 53(5): 575–581. Pub
  2. Clinical Biomechanics. Ability of magnetic resonance elastography to assess taut bands. 2008 Jun;23(5):623-9. Epub 2008 Feb 21.
  3. Schmerz. Diagnosis and therapy of myofascial trigger points. 2003 Dec;17(6):419-24.

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