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Myofascial pain syndrome and fibromyalgia

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Abstract

Myofascial pain syndrome and fibromyalgia represent two of the most common musculoskeletal disorders seen in clinical practice. Although evidence is not conclusive, these two syndromes appear to be distinct pathophysiologically. Trigger points represent a hallmark of myofascial pain whereas fibromyalgia is characterized by diffuse pain complaints. Characterization of the pain with fibromyalgia has been reproducible across patients and mapped out by the American College of Rheumatology. Both conditions require multidisciplinary therapy when not responsive to specific treatment plans. Both conditions benefit greatly from maintaining a regular physical therapy program. Cognitive and behavioral therapies as well as relaxation and coping strategies are effective modalities for many patients. Selective medications and nerve blocks in myofascial pain can help make patients more functional.

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References and Recommended Reading

  1. Travell JG, Simons DG:Myofascial Pain and Dysfunction.In InThe Trigger Point Manual: The Upper Extremities, Baltimore: Williams & Wilkins; 1983.

    Google Scholar 

  2. Simons DG:Muscular pain syndromes.In InAdvances in Pain Research and Therapy. Edited by Friction J. New York: Raven Press; 1990: 1–41.

    Google Scholar 

  3. McClaflin RR:Myofascial pain syndrome.Postgrad Med 1994,96:56–70. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  4. Sinald M, Merritt JL, Stillwell GK:Tension myalgia of the pelvic floor.Mayo Clin Proc 1977,52:717–722. ▸ View thePubMed notation for this reference.

    Google Scholar 

  5. Dexter JR, Simons DS:Local twitch response in human muscle evoked by palpation and needle penetration of a trigger point.Arch Phys Med Rehabil 1981,62:521–522.

    Google Scholar 

  6. Friction JR, Auvinen MD, Dykstra D, Schiffman E:Myofascial pain syndrome: electromyographic changes associated with local twitch response.Arch Phys Med Rehabil 1985,66:314–316. ▸ View thePubMed notation for this reference.

    Google Scholar 

  7. Hubbard DR, Berkoff GM:Myofascial trigger points show spontaneous needle EMG activity.Spine 1993,18:1803–1807. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  8. Mense S:Slowly conducting afferent fibres from deep tissue: neurobiological properties and central nervous actions.Prog Sensory Physiol 1986,6:139–219.

    Google Scholar 

  9. Mense S:Fine muscle afferents fibres and inflammation: changes in discharge behaviour and influence on gamma-motoneurones.In InPain and Afferent Fibers. Edited by Schmidt R. Wenheim: VCH Verlagsgeschaft; 1987: 165–175.

    Google Scholar 

  10. Soukup T, Dobovy P:Histochemical localization of dipepticdyl peptidase IV in muscle spindles of the rat.Histochem J 1985,17:579–581. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  11. Simons DG, Travell JG:Myofascial origins of low back pain: 2. Torso muscles.Postgrad Med 1983,73:81–91. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  12. Scudds RA, McCain GA, Rollan GB,et al.:Improvements in pain responsiveness in patients with fibrositis after successful treatment with amitriptyline.Rheumatol 1989,16(suppl 19):98–103.

    Google Scholar 

  13. Carette S, Bell MJ, Reynolds WJ,et al.:Comparison of amitriptyline, cyclobenzaprine, and placebo in the treatment of fibromyalgia.Arthritis Rheum 1994,37:32–40. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  14. Sufit RL, Peters HA:Nifedipine relieves exercise-exacerbated myalgias.Muscle Nerve 1984,7:647–649. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  15. Kelly M:The relief of facial pain by procaine/novocaine injections.J Am Geriatr Soc 1963,11:586–596. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  16. Reynolds MD:Myofascial trigger point syndromes in the practice of rheumatology.Arch Phys Med Rehabil 1981,62:111–114. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  17. Flor H, Birbaumer N:Comparison of the efficacy of electromyographic biofeedback, cognitive-behavioral therapy, and conservative medical interventions in the treatment of chronic musculoskeletal pain.Journal of Consulting and Clinical Pathology 1993,61:653–658.

    Article  CAS  Google Scholar 

  18. Buch C, Ditto B, Feuerstein M:A controlled evaluation of paraspinal EMG biofeedback in the treatment of chronic low back pain.Health Psychol 1985,4:307–321. ▸ View thePubMed notation for this reference.

    Article  Google Scholar 

  19. Goldenberg DL:Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.Curr Opin Rheumatol 1993,5:199–208. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  20. Goldenberg DL:Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.Curr Opin Rheumatol 1994,6:223–233. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  21. McCain GA, Scudds RA:The concept of primary fibromyalgia (fibrositis): clinical value, relation and significance to other chronic musculoskeletal pain syndromes.Pain 1988,33:273–287. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  22. Consensus Document on Fibromyalgia:. Copenhagen: Danish Rheumatic Association; 1992.

  23. Jacobsen S, Bredkaer SR:The prevalence of fibromyalgia and widespread chronic musculoskeletal pain in the general population.Scand J Rheumatol 1992,21:261–262. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  24. Wolfe F:Fibromyalgia: the clinical syndrome.Rheum Dis Clin North Am 1989,15:1–18. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  25. Jacobsen S, Peterson IS, Danneskiold-Samsoe B:Clinical features in patients with chronic muscle pain with special reference to fibromyalgia.Scand J Rheumatol 1993,21:69–76.

    Article  Google Scholar 

  26. Lorenzen L:Fibromyalgia: a clinical challenge.J Intern Med 1994,235:199–203. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  27. Simms RW, Roy SH, Hrovat M,et al.:lack of association between fibromyalgia syndrome and abnormalities in muscle energy metabolism.Arthritis Rheum 1994,37:794–800. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  28. Geel SE:The fibromyalgia syndrome: musculoskeletal pathophysiology.Sem Arthritis Rheum 1994,23:347–353.

    Article  CAS  Google Scholar 

  29. Bengtsson A, Henriksson KG, Larsson J:Muscle biopsy in primary fibromyalgia: light microscopic and histochemical findings.Scand J Rheumatol 1986,15:1–6. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  30. Yunus MB, Kalyan-Raman UP, Masi AT,et al.:Electron microscopic studies of muscle biopsy in primary fibromyalgia syndrome: a controlled and blinded study.J Rheumatol 1989,16:91–101.

    Google Scholar 

  31. Drewes AM, Andreasen A, Schroder HD:Pathology of skeletal muscle in fibromyalgia: a histo-immuno-chemical and ultrastructural study.Br J Rheumatol 1993,32:479–482. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  32. Bartels EM, Danneskiold-Samsoe B:Histological abnormalities in muscle from patients with certain types of fibrositis.Lancet 1986,i:755–757.

    Article  Google Scholar 

  33. Bennett RM, Clark SR, Goldberg L,et al.:Aerobic fitness in patients with fibrositis: a controlled study of respiratory gas exchange and 133Xenon clearance from exercising muscle.Arthritis Rheum 1989,32:454–460. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  34. Lund N, Bengtsson A, Thorborg P:Muscle tissue oxygen pressure in primary fibromyalgia.Scand J Rheumatol 1986,15:165–173. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  35. Bengtsson A, Henriksson KG, Larsson J:Muscle biopsy in primary fibromyalgia: light-microscopical and histochemical findings.Scand J Rheumatol 1986,15:1–6. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  36. Bengtsson A, Henriksson KG, Larsson J:Reduced high-energy phosphate levels in the painful muscles of patients with primary fibromyalgia.Arthritis Rheum 1986,29:817–821. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  37. Larsson J, Bengtsson A, Bodegard L,et al.:Muscle changes in work-related chronic myalgia.Acta Orthop Scand 1988,59:74–78. ▸ View thePubMed notation for this reference.

    Article  Google Scholar 

  38. Yunus MB, Kalyan-Raman UP:Muscle biopsy findings in primary fibromyalgia and other of nonarticular rheumatism.Rheum Dis Clin North Am 1989,15:115–134. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  39. Yunus MD, Kalyan-Raman UP, Masi AT,et al.:Electromicroscopic studies of muscle biopsy in primary fibromyalgia syndrome: a controlled and blinded study.J Rheumatol 1989,16: 97–101. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  40. Bennett RM:Fibromyalgia and the facts: sense or nonsense.Controversies in Clinical Rheumatology 1993,19: 45–59.

    CAS  Google Scholar 

  41. Bennett RM:Muscle physiology and cold reactivity in the fibromyalgia syndrome.Rheum Dis Clin North 1989,15: 135–147.

    CAS  Google Scholar 

  42. Jacobsen S, Wildschiodtz G, Danneskiold-Samsoe B:Isokinetic and isometric muscle strength combined with transcutaneous electrical muscle stimulation in primary fibromyalgia syndrome.J Rheumatol 1991,18: 1390–1393. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  43. Arroyo JF, Cohen ML:Abnormal responses to electrocutaneous stimulation in fibromyalgia.J Rheumatol 1993,20: 1925–1933. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  44. Diagnostic and Statistical Manual of Mental Disorders Washington, DC: American Psychiatric Association; 1987: 255–267.

  45. Wolfe F, Smythe HA, Yunus MB,et al.:The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee.Arthritis Rheum 1990,33: 160–172. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  46. Boissevain MD, McCain GA:Toward an integrated understanding of fibromyalgia syndrome. II. Physiological and phenomenological aspects.Pain 1991,45: 239–248. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  47. Payne TC, Leavitt F, Garron DC,et al.:Fibrositis and psychologic disturbance.Arthritis Rheum 1982,25: 213–217. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  48. Ahles TA, Yunus MB, Riley SD,et al.:Psychological factors associated with primary fibromyalgia syndrome.Arthritis Rheum 1984,27: 1101–1106. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  49. Krag NJ, Norregarrd J, Larsen JK,et al.:A blinded, controlled evaluation of anxiety and depressive symptoms in patients with fibromyalgia, as measured by standardized psychometric interview scales.Acta Psychiatr Scand 1984,89: 370–375.

    Article  Google Scholar 

  50. Hawley DJ, Wolfe F:Pain, disability and pain/disability, relationships in seven rheumatic disorders: a study of 1,522 patients.J Rheumatol 1991,18: 1552–1557. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  51. Burckhardt CS, Clark SR, Bennett RM:Fibromyalgia and quality of life: a comparative analysis.J Rheumatol 1993,20: 475–479. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  52. Moldofsky H:Sleep and fibrositis syndrome.Rheum Dis Clin North Am 1989,15: 91–100. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  53. Granges G, Zilko P, Littlejohn GO:Fibromyalgia syndrome: assessment of the severity of the condition two years after diagnosis.J Rheumatol 1994,21: 523–529. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  54. Middleton GD, McFarlin JE, Lipsky PE:The prevalence and clinical impact of fibromyalgia in systemic lupus erythematosus.Arthritis Rheum 1994,37: 1181–1188. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  55. Yunus MB, Hussey FX, Aldag JC:Antinuclear antibodies and connective tissue disease features in fibromyalgia syndrome: a controlled study.J Rheumatol 1993,20: 1557–1560. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  56. Baumstark KE, Buckelew SP, Sher KJ,et al.:Pain behavior predictors among fibromyalgia patients.Pain 1993,55: 339–346. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  57. Goodnick PJ, Sandoval R:Psychotropic treatment of chronic fatigue syndrome and related disorders.J Clin Psychiatry 1993,54: 13–20. ▸ View thePubMed notation for this reference.

    CAS  PubMed  Google Scholar 

  58. Wysenbeek J, Mor F, Lurie Y,et al.:Imipramine for the treatment of fibrositis: a therapeutic trial.Ann Rheum Dis 1985,44: 752–753. ▸ View thePubMed notation for this reference.

    Article  CAS  PubMed  Google Scholar 

  59. Travell JG, Simons DG:Myofascial, Pain and Dysfunction.In InThe Trigger Point Manual: The Lower Extremities. Baltimore: Williams & Wilkins; 1992.

    Google Scholar 

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Rauck, R.L. Myofascial pain syndrome and fibromyalgia. Curr Pain Headache Rep 1, 41–53 (1997). https://doi.org/10.1007/BF02938149

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