Table of ContentsView AllTable of ContentsCausesSymptomsSimilaritiesDifferencesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Similarities
Differences
Diagnosis
Treatment
The muscle pain present in bothfibromyalgia(FM) andmyofascial pain syndrome(MPS) is a reason why these two conditions are sometimes mistaken for one another or erroneously lumped together as one condition.While FM and MPS do resemble each other, they can be easily distinguished through a careful medical history and physical exam. A correct diagnosis is key to moving forward with an effective treatment plan.
Comparing these disorders from start (what causes them) to finish (how they are treated) can help you navigate a potential misdiagnosis or dual diagnosis.
Causes of Fibromyalgia and Myofascial Pain Syndrome
The pathogenesis of FM and MPS, meaning why these conditions develop in some people, remains unclear. Scientists, however, have explored many plausible theories.
One potential shared cause of FM and MPS involves a phenomenon calledcentral sensitization.In this condition, a person’s brain remains on high alert, perceiving normal sensations as “painful” or mildly painful stimuli as severely painful.
Besides altered pain processing in the nervous system, genetic and environmental triggers like sleep disturbances or stress may contribute to the development of FM or MPS. For MPS specifically, a muscle injury from engaging in strenuous repetitive activities or some other sort of trauma is a common trigger.
Lastly, hormonal changes may play a role, especially for FM, which is significantly more common in females than males.
Condition Symptoms
Some symptoms associated with MPS are similar to thesymptoms of FM, while others are linked to only one of these diagnoses.
Julie Bang / Verywell
Symptoms common to both MPS and fibromyalgia include:
Perhaps the greatest symptom difference between MPS and FM is the location of the pain. While muscle tenderness is the paramount symptom of both conditions, the pain seen in MPS is regional (e.g., localized to one anatomic area, like the right neck or shoulder) whereas the pain in FM is widespread or “all over.“
Another symptom difference between FM and MPS is that a person with MPS may only have pain for a short period of time, whereas the pain in FM is generally always chronic.
Lastly, it’s important to note that besides muscle pain, the other symptoms mentioned above (e.g., fatigue or numbness and tingling sensations) are overall reported more frequently in people with FM than MPS.
MPSRegional muscle tendernessPain for a short periodOther symptoms reported less frequentlyTrigger pointsFMWidespread muscle tendernessChronic painOther symptoms reported more frequentlyTender points
MPSRegional muscle tendernessPain for a short periodOther symptoms reported less frequentlyTrigger points
Regional muscle tenderness
Pain for a short period
Other symptoms reported less frequently
Trigger points
FMWidespread muscle tendernessChronic painOther symptoms reported more frequentlyTender points
Widespread muscle tenderness
Chronic pain
Other symptoms reported more frequently
Tender points
How Are They Diagnosed?
Trigger Points in MPS
Trigger points typically form after the tissue is injured and, for some reason, doesn’t heal properly. Experts don’t know why damage that heals normally in most people causes trigger points in others. However, studies suggest that muscle injury in some people leads to abnormalities where the nerve cells connect to muscle cells.
Understanding Trigger Points
Tender Points in Fibromyalgia
FM is diagnosed primarily on a person’s report of widespread pain. Multipletender pointson a physical exam are also commonly found, although their presence is no longer a requirement to receive a diagnosis.
The tender points of FM are different from the trigger points of MPS in that they represent exquisitely tender areas of muscles that hurt with simple manual pressure. In addition, the tender points of FM do not refer pain like the trigger points of MPS do.
Besides a history and physical exam, if your doctor is considering a diagnosis of FM (or MPS, for that matter), they may order blood tests to rule out other medical conditions. For example, an erythrocyte sedimentation rate (ESR) may be ordered to rule out an underlying inflammatory process. Likewise, athyroid-stimulating hormone (TSH) testmay be ordered to rule out thyroid disease. Both test results should be normal in FM.
As with MPS, there is no imaging test or scan to make or confirm a diagnosis of FM. Depending on a person’s symptoms, though, a doctor may recommend further studies (for example, asleep studysince sleep problems are common in FM).
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Treatment Options
As with symptoms and diagnosis, there is some overlap in the treatment of MPS, but also important differences.
MPS Therapies
The primary treatment of MPS is atrigger-point injection, sometimes called dry needling. With a trigger point injection, a doctor inserts a needle directly into the trigger point or into several places around the trigger point to loosen up the taut muscle bands. The doctor may also inject a pain-relieving medication, such as lidocaine.
Besides trigger point injection, other potential MPS therapies include:
Acupuncture
Acupuncture is an ancient Chinese practice similar to dry needling. While studies of its use in MPS are limited, they are promising, and many patients and practitioners report good results.
Physical Therapy
A special kind of therapy called spray-and-stretch is common for treating MPS. A physical therapist guides you through stretching exercises while spraying a numbing substance on your muscle. The therapist may also use certain massage techniques to loosen your muscles and trigger points. In addition, a therapist can work with you on factors such aspoor posturethat may contribute to MPS.
Oral Medications
Common drugs for MPS includenonsteroidal anti-inflammatory drugs(NSAIDs), such as Aleve (naproxen) and Advil (ibuprofen). Tricyclic antidepressants, such as Elavil (amitriptyline) or the serotonin-norepinephrine reuptake inhibitor Cymbalta (duloxetine), as well as muscle relaxants (such as Flexeril) are sometimes prescribed for the treatment of MPS.
Topical Medications
Topical capsaicin or lidocaine applied to the skin over the trigger point may also be used to treat MPS.
FM Therapies
A multidisciplinary approach is recommended for the treatment of FM, including both pharmacological and non-pharmacological strategies.
Medications
Research shows that trigger-point injections are not effective at relieving fibromyalgia tender points, andNSAIDsare not effective at treating FM pain.
However, similar to MPS, antidepressants like Elavil (amitriptyline) or Cymbalta (duloxetine) may be prescribed. The anticonvulsant Lyrica (pregabalin) may also be considered in the treatment of fibromyalgia.
Non-Pharmacological Strategies
Similar to MPS, physical therapy (albeit in different forms) and acupuncture may be incorporated into the treatment plan for someone with FM.
More specifically, for FM, following an exercise routine (e.g., biking, running, or swimming) has been found to reduce muscle pain. Yoga, cognitive-behavioral therapy, and biofeedback may also provide benefits for those with FM.
Summary
While fibromyalgia and myofascial pain syndrome resemble each other in certain aspects, they are very different conditions. Both conditions cause muscle tenderness, but MPS pain is usually regional and sporadic, while FM pain is widespread and chronic.
Proper diagnosis is necessary to receive the right treatment. Acupuncture, trigger point injections, physical therapy, and medications such as NSAIDs can help with myofascial pain syndrome, while trigger point injections and NSAIDs aren’t recommended for people with FM. For people with FM, a treatment plan may include antidepressants, physical therapy, and an exercise routine.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bourgaize S, Newton G, Kumbhare D, Srbely J.A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management.The Journal of the Canadian Chiropractic Association. 2018;62(1):26-41.Eller-Smith OC, Nicol AL, Christianson JA.Potential mechanisms underlying centralized pain and emerging therapeutic interventions.Frontiers in cellular neuroscience. 2018;12:35. doi:10.3389/fncel.2018.00035Bellato E, Marini E, Castoldi F, et al.Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment.Pain research and treatment. 2012;2012:426130. doi:10.1155/2012/426130Chandola HC, Chakraborty A.Fibromyalgia and myofascial pain syndrome-a dilemma.Indian journal of anaesthesia. 2009;53(5):575-81.Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L.Myofascial trigger points then and now: a historical and scientific perspective.PM & R: the journal of injury, function, and rehabilitation. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024Chen Q, Basford J, An KN.Ability of magnetic resonance elastography to assess taut bands.Clinical biomechanics. 2008;23(5):623-9. doi:10.1016/j.clinbiomech.2007.12.002Häuser W, Fitzcharles MA.Facts and myths pertaining to fibromyalgia.Dialogues in clinical neuroscience. 2018;20(1):53-62.Arnold LM, Clauw DJ, McCarberg BH.Improving the recognition and diagnosis of fibromyalgia.Mayo Clinic proceedings. 2011;86(5):457-64. doi:10.4065/mcp.2010.0738Desai MJ, Saini V, Saini S.Myofascial pain syndrome: a treatment review.Pain Ther. 2013;2(1):21-36. doi:10.1007/s40122-013-0006-yGoldenberg DL. Using Multidisciplinary Care to Treat Fibromyalgia.J. Clin. Psychiatry. 2009;70(5):e13-. doi:10.4088/jcp.7073cc6cKia S, Choy E.Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology.Biomedicines. 2017;5(2). doi:10.3390/biomedicines5020020Hassett AL, Gevirtz RN.Nonpharmacologic treatment for fibromyalgia: patient education, cognitive-behavioral therapy, relaxation techniques, and complementary and alternative medicine.Rheumatic diseases clinics of North America. 2009;35(2):393-407. doi:10.1016/j.rdc.2009.05.003Additional ReadingDesai MJ, Saini V, Saini S.Myofascial pain syndrome: a treatment review.Pain Ther. 2013;2(1):21-36.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bourgaize S, Newton G, Kumbhare D, Srbely J.A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management.The Journal of the Canadian Chiropractic Association. 2018;62(1):26-41.Eller-Smith OC, Nicol AL, Christianson JA.Potential mechanisms underlying centralized pain and emerging therapeutic interventions.Frontiers in cellular neuroscience. 2018;12:35. doi:10.3389/fncel.2018.00035Bellato E, Marini E, Castoldi F, et al.Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment.Pain research and treatment. 2012;2012:426130. doi:10.1155/2012/426130Chandola HC, Chakraborty A.Fibromyalgia and myofascial pain syndrome-a dilemma.Indian journal of anaesthesia. 2009;53(5):575-81.Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L.Myofascial trigger points then and now: a historical and scientific perspective.PM & R: the journal of injury, function, and rehabilitation. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024Chen Q, Basford J, An KN.Ability of magnetic resonance elastography to assess taut bands.Clinical biomechanics. 2008;23(5):623-9. doi:10.1016/j.clinbiomech.2007.12.002Häuser W, Fitzcharles MA.Facts and myths pertaining to fibromyalgia.Dialogues in clinical neuroscience. 2018;20(1):53-62.Arnold LM, Clauw DJ, McCarberg BH.Improving the recognition and diagnosis of fibromyalgia.Mayo Clinic proceedings. 2011;86(5):457-64. doi:10.4065/mcp.2010.0738Desai MJ, Saini V, Saini S.Myofascial pain syndrome: a treatment review.Pain Ther. 2013;2(1):21-36. doi:10.1007/s40122-013-0006-yGoldenberg DL. Using Multidisciplinary Care to Treat Fibromyalgia.J. Clin. Psychiatry. 2009;70(5):e13-. doi:10.4088/jcp.7073cc6cKia S, Choy E.Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology.Biomedicines. 2017;5(2). doi:10.3390/biomedicines5020020Hassett AL, Gevirtz RN.Nonpharmacologic treatment for fibromyalgia: patient education, cognitive-behavioral therapy, relaxation techniques, and complementary and alternative medicine.Rheumatic diseases clinics of North America. 2009;35(2):393-407. doi:10.1016/j.rdc.2009.05.003Additional ReadingDesai MJ, Saini V, Saini S.Myofascial pain syndrome: a treatment review.Pain Ther. 2013;2(1):21-36.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bourgaize S, Newton G, Kumbhare D, Srbely J.A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management.The Journal of the Canadian Chiropractic Association. 2018;62(1):26-41.Eller-Smith OC, Nicol AL, Christianson JA.Potential mechanisms underlying centralized pain and emerging therapeutic interventions.Frontiers in cellular neuroscience. 2018;12:35. doi:10.3389/fncel.2018.00035Bellato E, Marini E, Castoldi F, et al.Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment.Pain research and treatment. 2012;2012:426130. doi:10.1155/2012/426130Chandola HC, Chakraborty A.Fibromyalgia and myofascial pain syndrome-a dilemma.Indian journal of anaesthesia. 2009;53(5):575-81.Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L.Myofascial trigger points then and now: a historical and scientific perspective.PM & R: the journal of injury, function, and rehabilitation. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024Chen Q, Basford J, An KN.Ability of magnetic resonance elastography to assess taut bands.Clinical biomechanics. 2008;23(5):623-9. doi:10.1016/j.clinbiomech.2007.12.002Häuser W, Fitzcharles MA.Facts and myths pertaining to fibromyalgia.Dialogues in clinical neuroscience. 2018;20(1):53-62.Arnold LM, Clauw DJ, McCarberg BH.Improving the recognition and diagnosis of fibromyalgia.Mayo Clinic proceedings. 2011;86(5):457-64. doi:10.4065/mcp.2010.0738Desai MJ, Saini V, Saini S.Myofascial pain syndrome: a treatment review.Pain Ther. 2013;2(1):21-36. doi:10.1007/s40122-013-0006-yGoldenberg DL. Using Multidisciplinary Care to Treat Fibromyalgia.J. Clin. Psychiatry. 2009;70(5):e13-. doi:10.4088/jcp.7073cc6cKia S, Choy E.Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology.Biomedicines. 2017;5(2). doi:10.3390/biomedicines5020020Hassett AL, Gevirtz RN.Nonpharmacologic treatment for fibromyalgia: patient education, cognitive-behavioral therapy, relaxation techniques, and complementary and alternative medicine.Rheumatic diseases clinics of North America. 2009;35(2):393-407. doi:10.1016/j.rdc.2009.05.003
Bourgaize S, Newton G, Kumbhare D, Srbely J.A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management.The Journal of the Canadian Chiropractic Association. 2018;62(1):26-41.
Eller-Smith OC, Nicol AL, Christianson JA.Potential mechanisms underlying centralized pain and emerging therapeutic interventions.Frontiers in cellular neuroscience. 2018;12:35. doi:10.3389/fncel.2018.00035
Bellato E, Marini E, Castoldi F, et al.Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment.Pain research and treatment. 2012;2012:426130. doi:10.1155/2012/426130
Chandola HC, Chakraborty A.Fibromyalgia and myofascial pain syndrome-a dilemma.Indian journal of anaesthesia. 2009;53(5):575-81.
Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L.Myofascial trigger points then and now: a historical and scientific perspective.PM & R: the journal of injury, function, and rehabilitation. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024
Chen Q, Basford J, An KN.Ability of magnetic resonance elastography to assess taut bands.Clinical biomechanics. 2008;23(5):623-9. doi:10.1016/j.clinbiomech.2007.12.002
Häuser W, Fitzcharles MA.Facts and myths pertaining to fibromyalgia.Dialogues in clinical neuroscience. 2018;20(1):53-62.
Arnold LM, Clauw DJ, McCarberg BH.Improving the recognition and diagnosis of fibromyalgia.Mayo Clinic proceedings. 2011;86(5):457-64. doi:10.4065/mcp.2010.0738
Desai MJ, Saini V, Saini S.Myofascial pain syndrome: a treatment review.Pain Ther. 2013;2(1):21-36. doi:10.1007/s40122-013-0006-y
Goldenberg DL. Using Multidisciplinary Care to Treat Fibromyalgia.J. Clin. Psychiatry. 2009;70(5):e13-. doi:10.4088/jcp.7073cc6c
Kia S, Choy E.Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology.Biomedicines. 2017;5(2). doi:10.3390/biomedicines5020020
Hassett AL, Gevirtz RN.Nonpharmacologic treatment for fibromyalgia: patient education, cognitive-behavioral therapy, relaxation techniques, and complementary and alternative medicine.Rheumatic diseases clinics of North America. 2009;35(2):393-407. doi:10.1016/j.rdc.2009.05.003
Desai MJ, Saini V, Saini S.Myofascial pain syndrome: a treatment review.Pain Ther. 2013;2(1):21-36.
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