Sunday, April 09, 2006

Fibromyalgia and Chronic Myofascial Pain: A Must read!!!

Excerpts from an article by Devin J. Starlanyl © 2004

Title of article: Fibromyalgia and Chronic Myofascial Pain: A patient review

Isn't the following familiar?

in page 8,
"Some patients with multiple myofascial TrPs were denied any treatment or adequate treatment for pain because they did not have 11 of 18 tender points indicative of FMS. Their doctors did not recognize myofascial TrPs. They thought erroneously that trigger points were part of fibromyalgia, and much of the literature reflects that lack of knowledge. Research indicates that patients who do not yet have the 11 of 18 tender points may benefit from aggressive pain control to prevent further central sensitization. Some of these patients developed FMS that might have been prevented had they only received adequate care. Some doctors tested for pain on areas that were not part of the accepted FMS tender point diagram and pressed myofascial TrPs instead. When the patients reacted, they were accused of malingering."

And this the following is kind of like "darn! Why I suffered needlessly?" I was so "hardworking" is doing exercises, and I felt terrible after all those efforts. Exercise! Lose weight! No one, including my family members were sympathetic with me, when I thought those excercises I did was killing me. Just look at what it says here...

"One doctor had noted that the patient required a physical therapy stretching and strengthening exercise program. A later comment indicated that the patient reported that the patient had given the physical therapy program her best effort but it did not give her the anticipated help. Some patients dropped out when work hardening and strength training programs caused extreme worsening of undiagnosed TrPs. They were then called noncompliant and in some cases their insurance companies refused to pay for the program, so they went back. They became disabled. Delayed reactions to overworking stressed muscles were common. One patient stated “If I overdo it I pay for it for four days, and the second is the worst.”

I really recommend the article to anyone which the nagging suspicion or have been diagnosed as a possible FMS patient. There is so much that you could identify with (and with -not). I think it is crucial we distinguish clearly between CMP and FMS. These two spells a very different approach in management and also the prognosis. My doctor is going to get a copy tomorrow!

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