CMP and Fibromyalgia (FM) can be difficult to diagnose, especially since signs and symptoms may seem unrelated. Some clinicians diagnose FM only if the patient has at least 11 out of 18 tender points.

This test, however, was intended to be used to identify FM patients who meet the criteria for inclusion into research studies; it was never intended for use in clinical settings. A patient can have FM, even if 11 of 18 tender points are not present.^1,2,3,4,5. A comparison of some of the characteristics of CMP and FM can be found in the table below.

One interesting difference between the two conditions is that more women than men have FM, however CMP affects men and women in equal numbers. Another difference is that muscles in locations that are some distance from the MTP's of CMP have normal sensitivity. As you can see in the table above, with FM there is a generalized sensitivity. With both conditions, the key to successful treatment is identifying and controlling or eliminating perpetuating factors. This may involve changing to a healthy diet and avoiding excess carbohydrates, adding vitamin and mineral supplements, regaining restorative sleep, and adding some gentle exercise and stress-removing activities.

One Isn't Bad Enough

People with both FM and CMP face more than just the two sets of symptoms of both conditions. Today, more researchers are realizing that FM and CMP not only occur together, they reinforce each other. FM and CMP can interact. ⁶ The research by Dr. Roland Staud and others indicates that pain from localized Myofascial Trigger Points (MTP's) can perpetuate the central sensitization of FM.⁷

Physical therapy and all other forms of treatment must proceed very carefully when both of these conditions are involved, because any excess pain caused by the therapy can further sensitize the central nervous system. Any treatment regimen will be both more complicated and less successful than if the patient had only one of the two conditions.

Beneficial Treatment?

Furthermore, some of the treatments normally prescribed for FM patients can cause damage to CMP patients, and the reverse is also true. You cannot strengthen a muscle that has a MTP, because the muscle is already physiologically contracted⁶, for example. Too many physical therapists see a weakened muscle and immediately attempt to strengthen it without testing for the presence of MTP's. Attempts at strengthening a muscle with MTP's will only cause the MTP's to worsen and may develop satellites and secondaries.

In the context of FM, many different neurotransmitters are affected to different degrees and in different combinations in each patient. Other biochemical's in the body are also affected to different degrees. Various hormones may be involved. Histamine (a neurotransmitter), for example, is often an important factor when there are many allergic manifestations. The possible combinations are endless, so this is no place for a doctor who is unaware of the two conditions, especially when you figure in the possible combinations of MTP's.

Fibromyalgia Information

For more information concerning Fibromyalgia, including symptoms, possible causes and treatments, we suggest you visit our sister site, FM-CFS/ME RESOURCES.

Source(s):

1. Starlanyl D, Copeland ME. Fibromyalgia & Chronic Myofascial Pain, 2nd ed. Oakland CA: New Harbinger Publications, Inc; 2001.

2. Ibid. Fibromyalgia/myofascial pain syndrome: (www.toad.net/~mbarrash/fms/star-1.htm, www.toad.net/~mbarrash/fms/star-4.htm), (www.toad.net/~mbarrash/fms/star-5.htm, www.tidalweb.com/fms/bigpict.shtml)

3. Ibid. Tender points: (www.sover.net/~devstar/tpdef.htm)

4. Ibid. Guide[s] for relatives and companions: (www.sover.net/~devstar/relative.htm; www.toad.net/~mbarrash/fms/star-3.htm); (www.tidalweb.com/fms/guide.shtml; http://members.aol.com/ELECTRICAL/relatives.html); (www.fmaware.com/fminfo/manage/guiforrelacomp.htm); (www.ncf.carleton.ca/fibromyalgia/relguide.htm)

5. Ibid. What everyone on your healthcare team should know [about FMS/CMPS]: (www.sover.net/~devstar/teaminfo.htm)

6. Starlanyl D, Fibromyalgia (FMS) and Chronic Myofascial Pain (CMP). Information for Patients and Supporters. (http://www.sover.net/~devstar/define.htm)

7. Starlanyl D, Travell, Focus on Pain (Travell) Seminar Orlando, 2003 (notes by Devin J. Starlanyl) (http://www.sover.net/~devstar/focus_on_pain.htm)