Posted by Steve Middleton, MS, ATC, CSCS, CES, CKTP
Fibromyalgia is a condition characterized by widespread pain and tenderness. Due to this, it tends to be a symptomatic based diagnosis. The rationale is that increase in central sensitivity cre
ates enhanced sensitivity of the dorsal horn receptors of the spinal cord which influence the nociceptors in the peripheral nervous system. Functional MRIs of the brain have demonstrated this increased sensitivity causes exaggerated responses to external stimuli whereas the body can internalize even light touch as an extreme amount of pressure. Prior thought was that myofascial trigger points contributed to the central sensitivity however trigger points can be found in individuals without fibromyalgia and may not appear in patients with fibromyalgia.
New research is looking at the role of fascia in this condition. Fascia is separated into two layers: deep and superficial. The superficial fascia is highly innervated. It is also composed primarily of fibroblasts. In the event of injury or perceived injury, fibroblast activity and peripheral inflammation lead to thickening of the fascia. Since fascia is a tissue spread throughout the entire body, it seems to play a previously misunderstood role in chronic pain syndromes.
Reference
Liptan; J Bodywork Movement Therapies 14 (2010) 3-12. All rights reserved to Elsevier Ltd.
for more information, please visit: http://www.anatomyphysiotherapy.com
Dear Ms. Cooper,I have suffered from FM for more than 20 years. When first diagnosed I was told that FM was caused by a thickening and scarring of the fascia, which made it difficult and painful to move. Massage therapy, I was told, was an effective treatment because it broke down the scar tissue. Unlike my doctor at the time of diagnosis, most of the literature refers to ‘nerve pain’ as the root cause of FM. Rather than existing in a cormorbid state, is it possible that my initial diagnosis was correct?
I appreciate your response.
Hi Steve. It is possible to have fibromyalgia and myofascial pain syndrome as a comorbid condition. Studies are often flawed because subgroups of patients with FM alone, and FM and MPS are not identified. The same can be said for gender, nearly all studies include women only even though we know a certain number of men do in fact have FM.
Many studies suggest the presence of MPS in other syndromes and autoimmune disorders such as migraine, and, interstitial cystitis. Myofascial pain syndrome, chronic myofascial trigger points, is not an exclusive disorder. I have many studies posted on my website, I hope you will take a look.
In healing and hope, Celeste, RN, author, FM expert at Sharecare and participant in the Pain Action Initiative to Implement a National Strategy (PAINS)