Distinguishing Between Fibromyalgia Syndrome and Chronic Myofascial Pain

Fibromyalgia involves many different body systems and therefore is more “systemic” in nature than Chronic Myofascial Pain. That is why Fibro patients often have irritable bowels, insomnia, anxiety, headaches, irritable bladder and a host of other complaints. One of the main criteria for Fibro is that pain is not localized but more diffuse and often in all 4 quadrants of the body. Fibromyalgia patients have tender points located in very specific areas designated by the American College of Rheumatology. These tender points do not refer pain elsewhere when pressure is placed on them but they do cause severe localized pain.

In Chronic Myofascial Pain (CMP), the patient usually complains of more localized or regional pain. CMP patients have what is known as trigger points not the tender points found in Fibro. Trigger points differ greatly from tender points but often to an inexperienced practitioner they can be difficult to differentiate. The primary thing doctors need to observe is what is known as a referral patern. With trigger points and Chonic Myofascial Pain, the pain is referrred in a very specific pattern. FMS patients do not have this radiating pain patern when pressure is placed on a tender point.

Another important factor is that with Fibro, there is usually some degree of CMP that co exists. We call this co morbidity because it is one condition layered on top of the other. When patients present themselves with CMP, we often find that is all they have and Fibro is not present.

This is a very crucial point for people to understand because the treatment for these conditions is vastly different. CMP is much easier to treat because it is not systemic and is more a primary condition of the muscles. The trigger points that develop in CMP can easily be worked on and often when the trigger point is ‘broken up” the pain referral zone calms down and symptoms disappear. With Fibro, the treatment needs to be a more inclusive, overall approach because the condition involves many factors, numerous body systems and multiple causes. This is why it is vitally important to get an accurate dignosis by someone who has a good amout of experience telling these two conditions apart.