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Fibromyalgia (FMS) and Myofascial Pain Syndrome (MPS) are very different syndromes. The majority of physicians lump the
two conditions together, probably because they see many patients who have both FMS and MPS, which I call FMS/MPS Complex.
Unless doctors have a thorough knowledge of and familiarity with individual TrPs, they don’t stand a chance of sorting
out the different symptoms of the two different syndromes.
One interesting difference between the two conditions is
that more women have FMS than men. Myofascial Pain Syndrome, however, affects men and women in equal numbers. One important
difference is that in MPS, muscles located some distance from the trigger points have normal sensitivity, whereas in FMS,
there is an overall flu-like achiness, and generalized sensitivity, but no trigger points.
There are many medical
journal articles that explain why FMS and MPS are different, and why the difference is important. (See, for example, Borg-Stein
and Stein (1996), Schneider (1995), Simons, Travell and Simons (1998.)
People with FMS&MPS Complex face more than
just the two sets of symptoms of both conditions.
Fibromyalgia and MPS not only occur together, they reinforce and
amplify the symptoms of both. Because of this, physical therapy and all other forms of treatment must proceed very carefully.
Any treatment tried will be both more complicated and less successful than if the patient had only one of the two syndromes.
One study has already been done. Hong and Hsueh (1996) found that those with FMS and MPS experience more pain when they receive
trigger point injections, that the trigger point injections have less effect, and that the effect often takes longer to develop
and may not last as long than if the patients had MPS only.
In FMS&MPS, chronic pain exists, which is characterized
by the trigger points of MPS and many other symptoms. All of these symptoms and trigger points are intensified by the pain
amplification aspect of FMS. Furthermore, some of the treatments normally prescribed for FMS patients can damage MPS patients
and the reverse is also true. In FMS, many different informational substances may be affected in different combinations interacting
in different ways in different patients. Other biochemicals in the body are affected to different degrees. For example, histamine
(a neurotransmitter) is often an important factor when there are many allergic manifestations, but the possible combinations
of biochemical dysfunction are endless. When the possible combinations of TrPs are calculated, it is easy to see why no two
FMS&MPS Complex patients are alike. Fibromyalgia perpetuates MPS and the reverse is also true. The spiral of pain/contraction/pain/contraction
continues until it is interrupted by relief in some form. A lot can be done to relieve MPS and lighten the pain load. There
are many things that help FMS, as well. It’s important for people with this combination of syndromes to take on the
responsibility of managing their own treatment, seeing that the perpetuating factors are identified and dealt with as thoroughly
as possible. It isn’t easy, and it takes concentrated focus to change the habits of a lifetime. Getting as well as possible-optimizing
your quality of life-takes commitment. What is done to or for you can help a lot, but getting better is primarily a function
of what you do for yourself.
Fibromyalgia or Myofascial Pain Syndrome or both?
Differential features of Fibromyalgia & Myofascial Pain Syndrome
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