By Adrienne Dellwo
Fibromyalgia and myofascial pain syndrome often go together. Because of the frequent overlap and some similar symptoms, they’re often mistaken for the same condition and, as a result, people with both are sometimes only diagnosed with and treated for one.
Those are real problems, for three major reasons:
- They require different treatment
- MPS’s trigger points can be eliminated
- MPS pain can exacerbate FMS, and lowering MPS pain can calm FMS symptoms considerably
It’s also common for people with one of these conditions to be misdiagnosed with the other, which also leads to the wrong treatments.
Some researchers use the name “chronic myofascial pain” (CMP) instead of myofascial pain syndrome because of evidence it’s a disease, not a syndrome. (A “syndrome” is a set of symptoms without a known cause.)
In MPS, muscles and connective tissues (which make up the fascia) develop what’s called a trigger point (TrP). These are not the same as FMS tender points.
A trigger point is a small, hard knot that you can sometimes feel under your skin. The knot itself can be painful, especially when poked, but it often causes pain in another area, which is called referred pain.
Trigger points typically form after the tissue is injured and, for some reason, doesn’t heal properly. Experts don’t know why damage that heals normally in most people causes TrPs in others.
However, studies suggest that muscle injury in some people leads to abnormalities where the nerve cells connect to muscle cells. This suggests MPS is a neuromuscular disease.
Why people with MPS frequently develop FMS isn’t yet clear, but a growing body of evidence shows that, in some people, chronic pain can make changes to the central nervous system, resulting in central sensitization.
If theories are correct, early treatment of MPS may help prevent FMS.
An emerging umbrella term for FMS, MPS, and other conditions involving central sensitization is central sensitivity syndromes.