Fibromyalgia Syndrome (FMS) is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. It is also characterized by restless sleep, tiredness, fatigue, anxiety, depression, and disturbances in bowel functions. The etiology of fibromyalgia remains unknown, but recent advances and discoveries have helped to unravel some of the mysteries of this disease. Research highlights some of the biochemical, metabolic, and immunoregulatory abnormalities associated with fibromyalgia. Management of FMS at the present time is very difficult as it has multiple etiological factors and psychological predispositions; however, a patient centered approach is essential to handle this problem
FMN72_New (fibromyalgiaforums.org)
Widespread Pain Index or WPI score score
Symptom Severity Score (SS score)
Myofascial pain syndrome (MPS) is a regional pain disorder thought to arise from increased muscle tension. Its cause is poorly understood, but current thought attributes it to sustained muscle contraction lead-ing to local ischemia and release of pro-inflammatory chemicals,prompting more acetylcholine release via an autonomic positive feed-back loop, causing pain sensitization and referred pain.
A sedentarylifestyle is a risk factor for MPS, and daily exercise appears to be pro-tective.
Medical conditions, including hypothyroidism, chronic Lymedisease, and vitamin deficiency are also risk factors, as are psychologi-cal stressors and sleep disorders.
MPS presents as regional, persistent pain and increased muscle tension. Trigger points in areas of increased muscle tension that refer pain in specific “sclerotomal”patterns—are the primary physical examination finding, but identification of trigger points is hampered by poor interrater reliability. Many authors note a “twitch response,” where snapping or injecting of ataut band of muscle leads to a palpable, transient contraction of a group of muscle fibers. Trigger points are found most frequently in the upper limb, shoulder girdle, and neck, as well as the quadratus lumborum and gluteus medius. MPS is a clinical diagnosis and cannot currently be confirmed or excluded by any diagnostic testing. Treat-ment for MPS includes oral medication, including muscles relaxers andtricyclic antidepressants; topical nonsteroidal anti-inflammatory drugs(NSAIDs); physical therapy, activity modification and sleep hygiene;and injections with local anesthetics, botulinum toxin, and dry needling.