Fibromyalgia & Myofascial Pain Syndrome
Introduction
Fibromyalgia is a complex, chronic condition which causes widespread pain and fatigue as well as a variety of other symptoms. On the other hand Myofascial Pain Syndrome is manifested as localized muscle spasm and pain with the presence of its pathognomonic feature, the trigger points in certain areas. In Fibromyalgia Syndrome in addition to Myofascial Pain there will be certain other systemic features. Fibromyalgia is a systemic disease & difficult treat; on the contrary Myofascial Pain Syndrome is localized problem and curable.
Fibromyalgia is defined only recently, but it is not recently discovered. Descriptions have been found in the medical literature as far back as the early 17th century. Many physicians question its existence. In the past, poor recognition and lack of treatment for fibromyalgia could be explained by a lack of meaningful research. Today, abundant research and medical evidence supports the diagnosis of fibromyalgia.
Fibromyalgia syndrome (FMS) is an under diagnosed disorder of unknown etiology affecting 2-4% of the general population, women more often than men (Wolfe 1993) 1. Patients complain that they ache all over. A large number of other symptoms are often present, particularly fatigue, anxiety & depression, sleep disturbance, morning stiffness, paresthesias, and headaches. On examination, areas of focal tenderness called tender points/trigger points can be demonstrated in characteristic locations.
Diagnosis:
It was only in 1990 that official diagnostic criteria for FM were established by the American College of Rheumatology (ACR).2
Chronic, widespread, musculoskeletal pain lasting longer than three months in all four quadrants of the body. (“Widespread pain” is defined as pain above and below the waist and on both sides of the body.) In addition, axial skeletal pain (in the cervical spine, anterior chest, thoracic spine, or low back) must be present. There are 18 tender points that doctors look for in making a fibromyalgia diagnosis. According to the ACR requirements, a patient must have 11 of the 18 to be diagnosed with fibromyalgia. Approximately four kilograms of pressure (or about 9 lbs.) must be applied to a tender point, and the patient must indicate that the tender point locations are painful.
