Myofascial Pain Syndrome Compared to Fibromyalgia

Dr. Mark Borigini wrote a really great and insightful post over at Chronic Pain Connection on the difference between Myofasical Pain Syndrome versus Fibromyalgia. Dr. Borigini states in his article that many people are diagnosed with Fibromyalgia due to having chronic soft tissue pain. But just because they have this sort of soft tissue pain does not mean their diagnosis should be Fibromyalgia in all cases.

This is the one thing that irritates me about Fibromyalgia. I’m glad that the illness is being accepted more now but it seems that many doctors are using it as a wastebasket diagnosis and diagnosing people with it when there is something else going on.

The doc says that localized or regional pain is often due to a condition called Myofascial Pain Syndrome. MPS is a common condition that affects certain muscle areas. MPS may be present in Fibromyalgia patients but not all Fibromyalgia patients have MPS.

According to Dr. Borigini:

MPS generally involves pain in the neck, shoulders, hips, back, jaw and head. This pain is often accompanied by stiffness or tightness. It is important that the doctor listen to the patient to learn where the pain is most intense. And because MPS is not diagnosed with a lab test or x-ray, it is important that the doctor carefully examine the patient.

Trauma is a common cause of MPS, in the form of muscle strain or ligament and tendon sprain; or as a result of chronic trauma due to repetitive work injury, or altered posture due to poor exercise. An example of the former is whiplash from an auto accident. An example of the latter is an individual who works at a computer all day, and subsequently develops MPS involving the muscles of the upper back and shoulders; such individuals often develop tension headaches. Of course, more than one area may be involved, and this can make distinguishing between MPS and fibromyalgia all the more difficult.

MPS can occur with a variety of medical problems, including spinal disc disease, or inflammatory illnesses. And like fibromyalgia, MPS symptoms can be made worse due to stress, depression, fatigue and vitamin deficiencies, to name a few.

It is important for the doctor to identify all other illnesses in an individual patient so that therapy can be most effective and accurate.

There is no cure for Myofascial Pain Syndrome but treatment is available. The goal of treatment should involve using a combination of therapies: pain medication and improvement of mobility and functionality. MPS patients also need to be educated on how best to manage their pain and to deal with the illness.

Now that we know that MPS and Fibromyalgia can be misdiagnosed, what are the differences between the two?

1. MPS has more localized or regional pain versus the diffuse pain of Fibromyalgia.
2. MPS patients have “trigger points” which can cause pain at a distant location when pressed, where Fibromyalgia patients suffer from “tender points.”
3. MPS has a better prognosis, as the pain often resolves with treatment or the rectification of the offending stimulus; the pain of fibromyalgia has a much higher chance of being chronic.