Difference between fibromyalgia and myofascial pain syndrome

Fibromyalgia vs Myofascial pain syndrome

Fibromyalgia, in simple English, can be understood as pain of muscles and connective tissues at multiple sites on the body. It largely affects females and its chances increase with age. Myofascial pain syndrome is characterized by localized musculoskeletal pain in one or two spots along with tenderness.

Causes of fibromyalgia are not very clear but there are many hypotheses. Inadequate or disturbed sleep or awakening un-refreshed has been thought of as a possibility. Often there is a deficiency of a hormone called serotonin in the patients. Serotonin is a hormone which regulates pain and sleep. Growth hormone levels are also altered in these patients. Growth hormone is essential for muscle repair and strength and is produced during stage 4 of sleep. Reduction in growth hormone in these patients explains the extended pain felt by them. This type of pain is seen in patients suffering from depression and anxiety.

Fibromyalgia is a functional disorder seen in association with psychiatric disorders, whereas myofascial pain syndrome is seen mostly due to physical stress and injury. In myofascial pain syndrome, pain occurs due to overuse, strain, injury or prolonged contraction of a muscle or group of muscles, especially when reading or writing at a desk or on a computer. Pain is generally referred from specific (trigger) points to muscles which are distantly located.
In fibromyalgia there is muscle pain, stiffness and fatigue. There is lower back pain, pain radiating from the back to the buttocks and legs. Stiffness is felt more on waking up in the morning and resolves during the day. Patients complain of feeling fatigued and exhausted and waking up tired. Also, patients experience migraine-like headaches occasionally. The most characteristic feature is painful tenderness over neck, shoulder, elbow, knee joint and around the buttocks. These points are bilaterally painful in all cases. Symptoms are aggravated by emotional stress, infection, etc.
AN example of myofascial pain syndrome is headache due to a trigger point in the neck muscles due to strain. Another example is of pain in the lower back giving rise to pain in the buttocks. Myofascial pain syndrome is pain involving a small area of the shoulder, which represents a part of the condition of fibromyalgia. Myofascial pain, if not attended to in time, might lead to fibromyalgia in patients who are very anxious or who have symptoms of depression.
Fibromyalgia is diagnosed by a history of widespread musculoskeletal pain present for a minimum of 3 months and demonstration of significant tenderness or pain in majority of sites. In the case of fibromyalgia, patients are counseled that their disease is not crippling nor deforming and lot of treatment options are available. The first step of treatment of fibromyalgia is use of tri-cyclic antidepressants to improve sleep. Once sleep improves, the hormones are produced appropriately in the body and, hence, patients start feeling better. Next in line is the anxiety or depression treated with anti-depressants and psychiatric counseling. Patients will eventually improve with aerobic exercises but exercises must be easy and of short durations, gradually increasing the strength. Lastly, stresses of life should be spoken of and patients should be encouraged to discuss with family members who can help them cope.
In myofascial pain syndrome, since the cause is physical stress, massage, ice packs and application of ultrasound to the part are beneficial. These patients should be advised on how to prevent muscle strain related to work and recreation. Rest should be given to muscles which are in prolonged use, as rest at intervals will prevent muscle tension.

Summary:
Myofascial pain syndrome is a concentrated form of fibromyalgia. If it is not treated in time, it might lead to fibromyalgia.

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