Fibroymalgia and Myofacial Pain

Almost always, Myofascial Pain Syndrome (MPS) is misdiagnosed as Fibroymalgia (FM). And yet in almost all cases, FM patients have MPS.

A person with MPS has acute pain and areas of muscular tension and sensitivity called trigger points. In the areas of the trigger points, the pain is more intense with a radiating pattern along the same muscle or muscle group. The patient complains of a decrease in the range of motion, as well as a significant weakness in muscles containing active trigger points. The patient feels better when the muscle is at rest, and the intensity of the pain increases as soon as the affected muscle starts to contract. One of the main clinical differences between FM and MPS is the distribution of pain. In MPS, the pain has local character and if it radiates, the patient feels it along the same segment. MPS affects all age groups and both genders. There are no accompanying syndromes. Please note that sharper levels of pain do not bring about a decrease in serotonin level. Rather, a low-grade persistent pain such as in FM, is the causative factor in serotonin level decrease.

The intensity of the pain in FM is much lower than in a person with just MPS, but it is persistent. Pain is present regardless of contraction or relaxation of affected muscles. Low-grade, persistent, psychologically-exhausting pain is one of the main symptoms of FM. Another difference is poor localization of pain, which seems to affect other soft tissues as well (e.g., skin, fascia and periosteum). Finally, the FM patient may exhibit pain either over the entire body or have patchy localizations of pain. In the case of the latter, affected areas are separated by unaffected areas. For example, the patient will complain of headaches, pain in the lower back and gluteal areas, and in the plantar fascia of the feet.

Contrary to MPS, FM carries a very strong psychological component. The patient is usually depressed, suffers from mood swings, easily bursts into tears, has significant sleep disturbances, and is mentally and physically fatigued. Additionally, the patient may have many related physical complaints: migraines, bruxism (teeth grinding), TMJ problems, irritable bowel syndrome, pelvic pain, tachycardia (increased cardiac rate), Raynauld’s phenomenon and chronic rhinitis.

The pain-causing physical expressions of chronic inflammation consist of mild swelling of the soft tissue, tension in fascia, pathological hypertonus of muscles, significant decrease in blood supply and calcium depositing in the soft tissue.