By Anne Asher,
Myofascial pain syndrome and fibromyalgia are two different chronic pain conditions, although they both are characterized in part by palpable “points.” Aside from this shared symptom — most people with fibromyalgia have active trigger points, which is also one of the main symptoms of myofascial pain syndrome — most of the remaining symptoms for each condition could not be more distinct from one another.
Fibromyalgia is often described as chronic widespread pain felt in all four limbs and in the trunk.
Previously, a diagnosis of fibromyalgia was made when 11 of 18 pre-defined tender points were sore or elicited a pain response upon evaluation.
But in 2011, and again in 2016, the diagnostic criteria changed, perhaps because pain at the pre-defined tender points can change, even from day to day. Now your doctor will likely diagnose you with fibromyalgia if you’ve had widespread pain for at least three months and if you also have other symptoms such as fatigue — even when you wake up in the morning. Confused thinking is another key symptom.
Other things that changed in 2016 in the fibromyalgia diagnostic criteria include a higher score on the widespread pain index, generalized pain in at least 4 of 5 body regions that don’t include jaw, chest and/or abdominal pain, and perhaps most important to patients who feel that it’s hard to get their symptoms taken seriously is that if you’ve been diagnosed with other conditions or diseases as well as fibromyalgia, the fibromyalgia diagnosis is valid.
Myofascial Pain Syndrome
Myofascial pain syndrome is defined by trigger points, which are felt as taut bands of muscle. The trigger points refer pain to other (nearby) locations in the body. When pressed, trigger points elicit a twitch response, also known as a “jump sign.” One of the main characteristics of myofascial pain syndrome is that the pain is regional, or confined to a limited area of the body.
Generally, myofascial pain will be found in the shoulders, neck, arms, face, low back and/or legs. It is quite often a result of misaligned posture.
Myofascial pain syndrome can be treated in a number of ways, including injections, stretching with the use of a cooling spray (a method called spray and stretch), and specific manual or massage techniques that eradicate the trigger points.
People with myofascial pain and trigger points tend to have tight muscles and limited flexibility. Myofascial pain syndrome occurs in an approximately 1:1 male to female ratio.
A Summary of the Differences Between Myofascial Pain Syndrome and Fibromyalgia
As you’ve likely know by now, fibromyalgia and myofascial pain syndrome are two very different problems. Fibromyalgia is a widespread pain syndrome accompanied by fatigue and muscle tenderness, with symptoms that are not associated with inflammation.
Treating fibromyalgia is often multidisciplinary. For example, you may need gentle to moderate exercise, counseling, and anti-depressants all at the same time.
Myofascial pain, on the other hand, is the condition of muscles that occurs when trigger points cause reduced functioning in soft tissue. Of course these trigger points lead to pain, as well.
Myofascial pain syndrome often benefits from treatments that are physical in nature, such as manual medicine and restorative movement. One key goal of the care is to improve your postural alignment.
Research also supports the use of injections as a way to relieve pain from trigger points in people with myofascial pain syndrome.. For people with fibromyalgia tender points alone, however, treatment with injections has not shown to be very effective. This is one notable difference between fibromyalgia and myofascial pain syndrome as published in medical literature.
But new treatments are on the horizon for people with myofascial pain syndrome.
A 2017 study published in the Journal of Back Musculoskeletal Rehabilitation found that a combination of the usual mechanical treatment with a vibration type treatment called Cellconnect Impulse yields better pain relief and other outcomes than do the conventional procedures alone.
If you are considering injections for myofascial pain or for fibromyalgia, ask your doctor to explain your options carefully and thoroughly.
Schneider, R. Effectiveness of myofascial trigger point therapy in chronic back pain patients is considerably increased when combined with a new, integrated, low-frequency shock wave vibrotherapy (Cellconnect Impulse): A two-armed, measurement repeated, randomized, controlled pragmatic trial. J Back Musculoskelet Rehabil. Aug. 2017.
Simons, D., MD, Travell, J. MD, Simons, L., PT. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1 Upper Half of the Body. 2nd Edition. Williams & Wilkins A Waverly Company 1999. Baltimore.
Wolfe, F., et. al. 2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria American College of Rheumatology Meeting Abstracts. September 2016.