| Myofascial Pain Syndrome (MPS) / Fibromyalgia Syndrome (FMS) |
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What is myofascial pain syndrome (MPS)/fibromyalgia syndrome (FMS)?MPS is a very common pain syndrome which involves pain in various muscles, ligaments, and tendons (also known as rheumatism and closely related to fibromyalgia syndrome). The symptoms usually start in one muscle group and they may spread to other parts of the body. Patients with this problem may be sleep-deprived, have limited range of motion of major joints, experience diffuse soft tissue pain, and often suffer depression. For many years, this type of pain was not recognized or validated by the medical community. It is now viewed as a legitimate disorder that merits treatment. Fibromyalgia seems to be a somewhat related disorder but develops without antecedent injury, and rather than tight muscles, the patient may have extra pliable muscles. What are the causes?There is no known cause for myofascial pain syndrome (MPS) or fibromyalgia (FMS). Sometimes it can occur in several members of the same family (more often with women than men) suggesting that there may be a genetic factor. Often the pain is initiated by a trauma to a single muscle group, and slowly the pain spreads to other locations. The best evidence suggests that this problem is one of an "altered pain threshold" or sensitivity to pain, with MPS /FMS patients reporting more pain for a given amount of painful stimuli. This altered sensitivity can present as increased muscle tone and exquisite tenderness, especially in certain areas such as the trapezius muscles, levator scapulae, paralumbar muscles, and forearm extensors. Prior untreated depression, anxiety, and a history of childhood physical and sexual abuse seem to be risk factors for development of MPS. Hormonal disturbances have also been linked to these syndromes. Is myofascial pain syndrome/fibromyalgia preventable?Although there is no known cause for MPS/FMS, it is similar to many chronic medical conditions in that maintaining a healthy lifestyle - including good nutrition, daily exercise and adequate rest - seems to be the best means of prevention, though no guarantee. What treatment options are available?
Here at PainCare, treatment of this problem always involves a graded
aerobic exercise program, and often an antidepressant, muscle relaxant,
and anti-inflammatory. Trigger point injections with local anesthetic,
occasionally Botox, can be very effective for weeks or months
especially for more localized symptoms. Physical therapy can also be a useful treatment for select patients, and is
offered at Pinewood Physical Therapy. Narcotics are used as a last resort, but are unfortunately necessary in many severe cases.
When should I call PainCare?
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