Explaining Fibromyalgia (Myofacial Pain Syndrome)

5th August 2006 at 14:22 BST by Dr.C.A.Jenner MB BS, FRCA. Permalink.

The presentation, symptoms, signs and treatment of Fibromyalgia (Myofacial Pain Syndrome).

Fibromyalgia - The Condition

Widespread pain especially affecting the neck, shoulders and back, associated with multiple trigger points which, when touched can reproduce the pain.

Associated with a low mood and sleep disturbance.

Can occur on its own (primary) or can be secondary to a number of other, painful conditions including: Chronic Regional Pain Syndrome, Cervical Facet Joint Syndrome, Whiplash, etc.

Cause of Fibromyalgia is unknown but there are thought to be multiple factors.

Scientific research shows that patients who suffer from the pain of fibromyalgia have changes that occur in the peripheral and central nervous systems. These changes make patients hypersensitive and more likely to experience pain.

Clinical examination findings reveal multiple trigger points- these are taut bands of muscle which, when pushed (palpated) on examination reproduce the pain.

Treatment Options

Medication

• Mainstay of treatment- gabapentin, pregabalin, amitryptilline
• Other- paracetamol, non-steroidals (NSAIDs), weak opiates (codeine, dihydrocodeine)
• Medications can be given alone or in combination

Physical Therapy

• TENS machine

Alternative Therapy

• Acupuncture
• Shiatsu
• Deep Tissue Massage

Interventional Pain Medicine

• Injection of local anaesthetic and anti-inflammatory into trigger points.
• Injection of Botulinum toxin A (Botox or Dysport) into trigger points.