Chronic Pain: Myofascial Pain and Fibromyalgia

Abstract

Copyright: © 2013 Luo JJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Chronic pain is a common dilemma encountered in daily practice. However, optimal treatment of chronic pain is a clinical challenge, especially for patients with chronic myofascial pain (CMP) and fibromyalgia, known as fibromyalgia syndrome (FMS). CMP has also been termed myofascial pain syndrome, the usage of which is not recommended, because CMP is now recognized as a disease (see below). CMP is characterized by chronic pain caused by fascial constrictions and multiple regional trigger points. A fascia is a connective tissue surrounding muscles. A trigger point is a highly sensitive area within the muscle resulting from noxious stimuli and is painful to touch. Myofascial pain is extremely common, and everyone may develop a trigger point at some time in life. In the United States, an estimated 14.4% of the general population suffer from chronic musculoskeletal pain and 21-93% of patients with regional pain complaints of having CMP [1]. FMS is another medical condition characterized by chronic, widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood disturbances [2,3].The term “fibromyalgia” derives from Latin, fibro-, meaning “fibrous tissues”, Greek myo-, “muscle”, and Greek algos-, “pain”, which means “muscle and connective tissue pain”. FMS is estimated to affect 2–4% of the population [4,5], with a female to male incidence ratio of approximately 9:1 [6]. In contrast, CMP affects men and women equally. Both CMP and FMS most often affect 30-60 years-old individuals. The cost in care for chronic musculoskeletal pain is high in developed countries [7]. The annual cost of chronic pain in the United States, including healthcare expenses, lost income, and lost productivity, is estimated more than $100 billion [8].