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Fibromyalgia is believed to affect the way the brain processes pain signals and amplifies the sensation of pain.
Most people with chronic pain and fatigue in their muscles tend to have either fibromyalgia or myofascial pain syndrome (MPS). Fibromyalgia is a condition characterized by widespread musculoskeletal (involving the muscles and bones) pain accompanied by fatigue, sleep, memory, and mood issues. Fibromyalgia is believed to affect the way the brain processes pain signals and amplifies the sensation of pain. MPS is considered by many doctors a subtype of fibromyalgia syndrome and shares several similarities with fibromyalgia. MPS is characterized by localized pain in regional groups of muscles such as the jaw, neck, or lower back, whereas fibromyalgia is widespread throughout the body.
In MPS, there are few trigger points in the muscles that are tender and can produce localized pain. They also trigger referred pain (pain felt at a site distant from the site of damage or injury). Fibromyalgia is associated with multiple, more widespread tender points. Tender points are not the same as trigger points because tender points don’t cause referred pain. Many patients with fibromyalgia may also have other associated conditions such as tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome (IBS), anxiety, or depression. Fibromyalgia and MPS are lifelong disorders with no cure, but there are various treatment options that can help reduce symptoms and improve the quality of life.
What are the signs and symptoms of fibromyalgia?
Symptoms may begin after acute psychological stress, physical trauma, surgery, or other systemic infections. Sometimes, there may be no identifiable trigger.
A patient with fibromyalgia typically presents with the following:
- Widespread pain: The pain is constant and dull, lasting for at least three months. The pain occurs throughout the body, on both sides of the body, and below and above the waist.
- Fatigue: Patients with fibromyalgia are always tired, and they even wake up feeling tired despite sleeping for long periods of time. The pain can even cause sleep disturbance. Patients also have other sleep disorders, such as restless leg syndrome (uncontrollable urge to move legs due to some uncomfortable sensations) and sleep apnea (temporary cessation of breathing during sleep).
- Cognitive difficulties: This is also referred to as “fibro fog.” Fibromyalgia affects the ability to focus and pay attention to mental tasks.
What are the signs and symptoms of myofascial pain syndrome?
The common signs and symptoms of myofascial pain syndrome (MPS) include:
- Deep pain in specific areas of the muscles, which worsens when the muscles affected get stretched or strained.
- There is muscle pain that worsens or fails to improve with time.
- Presence of painful and tender knots in the muscles. Pain increases in applying pressure on the knots.
- Stiffening of the muscles, decreasing flexibility, and reducing the range of motion.
- Mood changes.
- Insomnia (decreased sleep or inability to sleep).
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What characterizes fibromyalgia?
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What causes fibromyalgia and MPS?
The exact causes of fibromyalgia and myofascial pain syndrome (MPS) are unknown, but various factors are found to play a role in their cause. These may include:
- Genetics: Fibromyalgia and MPS has been found to run in families. There may be certain genetic mutations that increase the risk of disorder.
- Infections: Certain systemic illnesses may trigger or aggravate the condition.
- Physical or emotional trauma: Fibromyalgia and MPS can sometimes be triggered by acute psychological stress or physical trauma such as an accident.
What are the risk factors for fibromyalgia?
Risk factors for fibromyalgia include:
- Female sex: Fibromyalgia and myofascial pain syndrome (MPS) are more common in women than in men.
- Family history: Positive family history increases the risk.
- Other disorders: Other conditions such as osteoarthritis, rheumatoid arthritis, or lupus can increase the risk.
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How are fibromyalgia and MPS treated?
Treatment options for fibromyalgia include:
- Painkillers: Over-the-counter pain relievers such as Tylenol (acetaminophen) and Advil (ibuprofen) and prescription painkillers can help reduce symptoms. Narcotics are not usually used because they can lead to dependence and may worsen the pain over time.
- Antidepressants: Anti-depressants such as Cymbalta (duloxetine) and Savella (milnacipran) and muscle relaxants may be prescribed to help reduce pain and fatigue associated with fibromyalgia.
- Anti-seizure medication: Medications used to treat epilepsy may be useful in reducing certain types of pain.
- Physical therapy: A physical therapist can teach you exercises that will improve your strength, flexibility, and stamina. Water-based exercises might be particularly helpful.
- Occupational therapy: An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body.
- Stress management: Managing physical and emotional stress is essential in the treatment of fibromyalgia. Stress management techniques such as deep-breathing exercises, yoga, or meditation can help. Seeking help from a professional therapist may be required.
- Adequate sleep: Because fatigue is one of the characteristic presentations of fibromyalgia, sufficient rest, and practicing good sleep hygiene is essential.
- Exercise and diet: Initially, exercise can increase pain, but exercising regularly reduces pain gradually. Exercises may include walking, swimming, biking, water aerobics, yoga, or dance. A physical therapist can help develop an exercise regimen. Eating a healthy, balanced diet and limiting caffeine intake is important in the management of fibromyalgia.
What happens if you go untreated for fibromyalgia and MPS?
Fibromyalgia and myofascial pain syndrome (MPS) are typically not life-threatening but can affect the quality of life. Pain, fatigue, and lack of sleep that occurs in both conditions can impair the ability to function at home or work. Patients may also feel frustrated due to their condition and can lead to anxiety or depression. With appropriate treatment, these complications can be managed.