Myofascial Pain Syndrome, Trigger Points, Fibromyalgia, Definition Diagnosis Triggers and Treatment Options

Myofascial Pain Syndrome, Trigger Points and Fibromyalgia: Definition, Diagnosis, Triggers and Treatment Options

Myofascial Pain Syndrome (MPS) is a term I came across in 2017, when a physiotherapist finally explained that this is what was causing my severe neck issues. In this post we go through what it is, examine if it’s part of Fibromyalgia, and my at-home treatments.

Myofascial Pain Syndrome, Trigger Points, Fibromyalgia, Definition Diagnosis Triggers and Treatment Options

Definition of Myofascial Pain Syndrome

A good definition of Myofascial Pain Syndrome that I have come across explains it as: “hyper irritable spots, usually within a taut band of skeletal muscle or in the muscle’s fascia that is painful on compression and can give rise to characteristic referred pain, tenderness, and autonomic phenomena” 1

Are Trigger Points Part of Fibromyalgia?

There is often confusion between the tender points characteristic of Fibromyalgia and trigger points. This article discusses the differences and similarities and provides a chart for distinguishing between the two.

The propensity for medical professionals to throw every symptom into the Fibromyalgia basket set me back for a decade. If they had realised prior to 2017 that my neck pain was really caused by trigger points, then we could have begun working on them sooner. These tiny hyper irritable spots have caused me over ten years of sleepless nights and 24/7 pain that nothing completely relieved.

Whether or not one wants to accept trigger points as part of Fibromyalgia or separate, research has noted that where trigger points are present in those with Fibromyalgia, the treatment of trigger points relieves the Fibromyalgia symptoms associated – such as pain in that area and fatigue.

Diagnostic Criteria for Myofascial Pain Syndrome

MPS does not have universally accepted diagnostic criteria, so it also does not have reliable statistics as to the prevalence. An estimate, using data around musculoskeletal pain in general puts estimates of myofascial pain as a patient’s primary complaint at 30%. 2

Other posts you may like:

Tools to Fight Fibromyalgia
My Top Three Treatments to Fight Fibromyalgia
9 Inexpensive Items I Use to Fight Fibromyalgia (including items I use to treat trigger points)

Causes or Contributing Factors for Trigger Points

  • Fibromyalgia or other conditions, especially inflammatory ones
  • Sleep deprivation
  • Postural (including bad ergonomics at the computer)
  • Trauma to the area
  • Excessive or lack of exercise
  • Emotional stress
  • Fatigue
  • Nutritional deficiencies
  • Excess weight

Treatment for Trigger Points

The above quoted literature review (2) discusses general treatments for MPS: aside from eliminating as many aggravators of the condition as possible (like proper ergonomic posture at computers), treating any other present diseases, the treatment usually includes NSAIDS (usually stated as unhelpful for Fibromyalgia), heat pack, and acupuncture applied by a specific methodology.

Myofascial Pain Syndrome, Trigger Points, Fibromyalgia: Definition, Diagnosis, Triggers and Treatment

Some treatment options

In my case, I found that placing acupuncture needles into the trigger point (gently, without aiming for muscle reactions like in dry needling) and leaving them in for 10-15 minutes followed by neck mobilisations and tractions, provides the best relief I have found. By going to a physiotherapist to do this every three weeks, in addition to my home treatment plan, is the best way to treat the trigger points. But they always come back. We have made some progress over the past year, but they are always there and re-triggered rather easily.

Whatever may work for you, it is likely to be multi modal – involving a few treatment options, including pharmacologic and alternative approaches.

My At-home Treatments for Trigger Points:

  • Heat: heat pack, hot bath or shower
  • Topical creams: Essential oil blended pain cream, Deep Heat
  • Trigger Point Massager cane for self-trigger point activation (you can use your fingers or thumbs but mine get too sore for the level of pressure needed)
  • Rest/pacing
  • Stretching
  • Limiting computer time and using good ergonomic set up
  • Medicines: Brufen, when they get to spasm level then a muscle relaxant

Your turn: Do you have trigger points too? How do you treat them?

  1. Travell, JG, Simons, DG. Myofascial Pain and Dysfunction. The Trigger Point Manual: Upper Half of Body, 2nd edition. Lippincott, Williams & Wilkins, Baltimore 1988.
  2. Overview of soft tissue rheumatic disorders Author:Irving Kushner, MDSection Editor:Zacharia Isaac, MDDeputy Editor:Monica Ramirez Curtis, MD, MPH Literature review current through: Mar 2018. | This topic last updated: May 12, 2017. on UptoDate.com

For more information:

Come and join my free micro course You vs Fibromyalgia: Arm Yourself with Knowledge

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9 inexpensive items i use to fight fibromyalgia and move more freely

9 Inexpensive Items I Use to Fight Fibromyalgia

I haven’t tried any very expensive items for managing pain. We just don’t have the budget with all of my other vital costs. These items are inexpensive (around $30 and under) and make a huge difference to my quality of life. A lot of them are things you can do yourself to manage pain, and I am a big fan of that.
Affiliate notice: Please note that some of my links are affiliate links and I may make a small commission at no extra cost to you if you make a purchase using the link. Every little bit helps me to keep creating resources.
9 inexpensive items i use to fight fibromyalgia and move more freely

Trigger point cane massagertrigger point cane massager

This has been a great find for multiple reasons. The first of which is that my fingers can no longer massage my trigger point-laden neck. The second is that I can use it in any trigger point that I find. And the third is that I can more successfully treat trigger points at home. I still need to see the physiotherapist for intramuscular needles to release them, but this helps.

Yoga mat

More often than not, I don’t use it as I’m indulging where I am, as I am – say, next to the kids playing and I drop to forward bend for a nice back release. But when I go into my room, close the door and roll out my mat, it’s practice time! Yoga is one of my favourite ways to manage pain, fatigue and generally exercise.

Heat pack

I can’t live without this. When we went away to a house (once!) with no microwave, I tried so hard to use the oven with little luck. This is my favourite way to manage pain and my first line of defense, I haven’t had a day without using my heat pack in years.

Memory foam contoured pillow

When my neck is being more troublesome than usual, this is the only pillow I can use. I can’t really get a pillow shipped from the US so the link I provided is one that is very similar to the one I use, this also has a five year warranty (use that if needed!).

Travelling memory foam pillow

This is a life saver for the car or plane. I just don’t fit seats right, I’m quite short so I need a way to rest my neck or I get super sore super quick.

TENS machine

tens machineWhen I remember to get this out, I’m impressed. It helps release my back. However, I can’t tolerate it near my neck and that’s my usual issue. You attach small sticky dots to your muscles and choose a setting and level, then relax for the time you set it for. It’s like a really focused massage.

Swiss ballSwiss ball

When I am pregnant this was my best friend. I sit on it and do pelvic rocks or circles. Or I’d kneel on the floor and lean forward over it (letting my stomach chill at a slightly higher than table top position) – oh the relief. It’s also useful for exercise when you’re not pregnant, especially for core work. Remember to choose the right size for your height, being 5 foot 2 I use the 65cm, but most people will want to use the next size up. When using it for pregnancy you want to ensure that your hips are higher than your knees when sitting on it.

Foam roller

My foam roller is a very nice way to roll out tight, sore muscles in my upper thighs (on the floor on my side), lower back (standing against a wall) and upper back (standing against a wall). Do Google how to use one of these.

Deep Heat cream

Deep heat regular relief creamThis is one of my favourite creams for pain relief, aside from my essential oils, it is non-medicated and warming. Heat is my absolute favourite for treating pain. I go to bed with my heat pack and then apply Deep Heat when I wake around 3am to help release the muscles in my neck.
What items do you find useful for fighting Fibromyalgia?

For more information about fibromyalgia:

Come and join my free You vs Fibromyalgia micro course.

 

melissa vs fibromyalgia book angled shadowed

I wrote a book about all that I do to fight Fibromyalgia

Trigger Point Therapy

Having been plagued by spots of extreme tightness on various parts of my body for years that numerous physical therapists have attempted to release and only ever achieved a small but fleeting degree of success, I am keenly interested in the study of trigger points.

It started with an article that I’ve long since lost. It showed me a few key trigger points to do for my shoulders and neck to release stiffness and pain. I use these every night when I wake in pain due to my neck.

Some of my links are affiliate links, I may receive compensation at no extra cost to you if you purchase using these links. I never promote anything I don’t 100% support myself.

This fantastic article was posted on Fibro Daze recently and gives a good explanation of trigger points and has a video showing you how to deal with your neck to relieve dizziness.The Trigger Point Therapy Workbook

Now I am reading The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief by Clair and Amber Davies.

I am loving it!

Because I have so many active trigger points, I had to start with the ones that were screaming the loudest. My neck. I have been working on my sternocleidomastoid and trapezius muscles. The book gives an overview of the muscle, the symptoms the trigger points in these muscles cause, where pain is referred to, causes and treatment. It includes great instructions on how to deal with them safely, as pressure on arteries can cause havoc.

The theory is that you deal to your trigger points three times a day until they are no longer sensitive to touch. I am unsure how helpful this will end up being. I have a lot for trigger points and my body overreacts to stimuli.  For example, I get sore legs if I don’t exercise enough and if I overdo it!

This is not a Tiny Mission. This is a big piece of work. But I’m game! Giving myself the ability to treat my body is a big opportunity. It gives me power. It gives me control. It gives me the opportunity to help myself, not helplessly wait for my next treatment session with my muscles clenching tighter and tighter!

I have also made the decision to try trigger point injections for my neck if I can’t relieve the daily tightness. I can’t go back to work and look after my baby if I continue to have daily tightness and pain to the point of headaches, nausea and dizziness.

It’s very exciting. I’ll check in with it in a few weeks. Has anyone else tackled their own pressure points and found success?


Update March 2018

Trigger points have become such an important issue for me to face since realised I had myofascial pain syndrome. The trigger points in my neck being the biggest issue I have fought for  a long time. I see a physiotherapist every three weeks still. I also self-treat at home with my theracane trigger point massager, which I adore. It is so helpful to be able to treat myself at home and not hurt my poor fingers with the level of pressure that I need.


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