Celeste Cooper

Fibromyalgia (FM) is a central nervous system state of sensitization, whereas chronic myofascial pain is a peripheral neuromuscular problem, but it seems the two have a greater connection than suspected. Up to 90% of fibromyalgia patient have myofascial pain syndrome (AKA chronic myofascial pain) as a comorbid condition. MPS/CMP is not specific to FM, just ask the sports medicine specialist. However, not all patients with MPS/CMP develop the centralization of pain as seen in FM.

Myofascial rigger points (MTPs) are knotted up muscle fibers in a taut band of muscle. They are EASILY felt unless behind bone or other muscles, or the band of muscle affected is too tight.  Frequency specific microcurrent, interferential and TENs units block pain messaging, and a new devise ETPS is interesting,  (It helps locate the active MTP and treat it). Specific myofascial therapy is needed, because there is no medication that will affect a MTP. Therapies such as myofascial release, specific MTP therapy by a body worked trained in Travell and Simons, MTP injection, active release therapy, and self therapy are beneficial.

I am concerned about pharmaceutical companies being bedfellows with those in charge of our care. They seem to have a death grip on our physicians and us too. How did we get to a place where we think taking a pill is all we need?  "Why are we not being referred for proper physical care by those trained in myofascial medicine?"

Restless leg syndrome (RLS) is ten times more likely in FM and could explain, dysfunctional sleep (its cohort periodic limb movement.  estless leg syndrome could and most likely does, have a myofascial component with centralization, but how would we know without a physical assessment by someone educated to do so?

Another comorbid condition to FM is migraine. It too has a myofascial component; this is why research for alternative treatments, such as Botox, and trigger point specific therapy such as ETPS is being investigated.

Ignoring the importance of a physical exam in diagnosing FM will lead us, researchers and clinicians, down another twenty years of unsuccessful outcome. We as the patient must demand that they pay attention to the research so we may have successful therapies.

“Life is a safari, though it can be a rough ride, failing to enjoy our surroundings will cause a road block. The beauty is always there for the taking." - Celeste

Refer to the blog for resources.

All blogs, posts and answers are based on the work in Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection by Celeste Cooper, RN, and Jeff Miller, PhD. 2010, Vermont: Healing Arts press and are not meant to replace medical advice.  http://www.thesethree.com

Resources:

HY Ge , Y Wang, B. Danneskiold-Samsøe , et. Al., “The Predetermined Sites of Examination for Tender Points in Fibromyalgia Syndrome Are Frequently Associated With Myofascial Trigger Points.” Pain. 2009 Nov 13.

D. M. Niddam, R. C. Chan, S. H. Lee, T. C. Yeh, and J. C. Hsieh, “Central representation of hyperalgesia from myofascial trigger point,” NeuroImage 39 (2008): 1299–1306.

D.G. Simons, J.Travell, and L. S. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual, 2nd ed. (Baltimore: Williams and Wilkins, 1999.)

Viola-Saltzman M, et al "High prevalence of restless legs syndrome among patients with fibromyalgia: A controlled cross-sectional study" Journal of Clinical Sleep Medicine ,2010; 6: 423-427.