Saturday, September 27, 2014

Fibromyalgia and Chronic Myofascial Pain Syndrome: Are you misdiagnosed?

I am always getting questions about this. Some people know what fibromyalgia is, but not myofascial pain syndrome, so a lot of times, I tell people fibromyalgia is the closest thing to it. Some people who don't know any better mistake myofascial pain syndrome for fibromyalgia. I want to lay this out, so it's clear for everyone in the most basic way I can.

FIbromyalgia (FMS) and Myofascial Pain Syndrome (MPS) often go together. Because of the frequent overlap and some similar symptoms, they're often mistaken for the same condition and, as a result, people with both are sometimes only diagnosed with and treated for one. MPS can also evolve to FMS.  However, not everyone with MPS develops FMS. From what I've heard and read, early treatment of MPS may help prevent FMS (which is something you'd really want to avoid.) However, many symptoms do overlap.

The distinction between MPS and FMS is crucial for THREE main reasons:
1) They require different treatment.
2) You can eliminate trigger points.
3) MPS pain can exacerbate FMS, and treating MPS can calm FMS.

What a lot of people don't realize is that fibromyalgia has 18 very specific points to be diagnosed. I, personally, (only diagnosed with MPS), have only had pain in my neck, back and sometimes thighs. I've never felt any pain in my knees, elbows or chest. Any other pain that I've had with the base of my skull and hips have been caused by noticeable trigger points and most of that pain is gone now (thanks to trigger point injections). Here's a nice little diagram of the basic points for FMS.

FMS 18 points 
It is also important to take note the difference between tender points and trigger points. So basically, the muscle have generalized sensitivity with FMS, while with MPS, the muscle areas that are located away from the trigger points and their referral regions have normal sensitivity. With FMS, there is total body achiness, while with MPS, there are specific pains in specific areas. With MPS, the areas not affected by trigger points don't hurt, but with FMS, the areas outside the tender points still ache. FMS is a neuroendocrine disorder while MPS is a neuromuscular condition.

For the old people reading, you can click this to make it bigger. 
I guess if I'd have to choose, FMS probably sucks a little more. It's harder to treat and technically more chronic. Some people figure it out. (I have a friend who works out as much as she can and does acupuncture and it's managed. But, acupuncture didn't do a damn thing for me.) Unfortunately, a lot of people can't find a solution. MPS is still a nightmare (to me and a lot of other people, anyway) but there are physical points that can be treated and the outcome for people MPS is a little less bleak than for people with FMS.

To understand a little more about MPS, click on "My Diagnoses Dissected" tab.

Helpful links/links for reference:

Monday, September 8, 2014

Physical Therapy: A Necessary Evil

So much has been happening the past few weeks, sorry I disappeared!

Luckily, today I have been discharged from PT. 

This is really exciting because I really hate PT.  It doesn't mesh well with my personality. I don't do well with being constantly bossed around and naturally, I feel like I can do it better on my own.

My PT happily discharged me based on the agreement that I will be doing my own "wellness program". As much as I hate to admit it, I really do need to commit to it. Dr. Gerwin says once I'm "normal", I will have to work out 5 days/week. I gotta start sometime. It's progress, people.

At first I was really against the idea (surprisingly) of being discharged because I didn't think I was ready and am always worried about not doing things the correct way without someone watching me. But, really, when am I ever going to be truly ready?

I am actually starting to have more good days than bad and my "good days" are starting to feel like actual, real normal people good days rather than maybe-if-I'm-lucky-I'll-take-a-shower-today good days. 

So, consequentially, the OCD/control freak took over and after a long night of excessive pinning, this happened: 

It's not perfect yet and I will be laminating a pool excel chart so I can do all my pool exercises too (because I'm clearly insane), but my main goal is to try to go every day I feel good enough to. 

Over the course of the last year, I've also found a reformer pilates personal trainer who also has hypermobility (and a great sense of humor). I'm planning on starting up with her once a week again as well as re-joining the gym. I just bought a whole new set of resistance bands to take to the gym as well as my foam roller. (I know, guys, my life is super exciting/embarrassing.) 

I am also fully aware I will be "that girl" at the gym. 

This process is exciting but mildly terrifying. I'm nervous to make a mistake and screw it up like I did before. My over-ambitiousness is truly a blessing and a curse. Luckily, moving on from PT has always been part of the game plan to eventually being independent, out of the house and working again.

I have been trying my best to keep busy though. I get bored A LOT. My brother was home last week and I went shooting for the first time ever. I get so stir crazy and can't do any of my other favorite adrenaline-rushing activities, so this was all around pretty entertaining for a girl who never gets out of the house. 

The best news of the day: I may have an appointment (that I had initially scheduled for next May last January) on Wednesday with the leading hypermobility specialist at GBMC in Baltimore, recommended by Dr. Gerwin, Dr. Clair Francomano. I have been told, not only by Dr. Gerwin, that is she the person to see for JHS.  Seriously praying they confirm I have it tomorrow. 

If I do get the appointment, I'll recap the appointment with new helpful hints. 

Have a good night everyone! 


Someone else got the Francomano appointment before I did. Sad face. Guess I'll see her next May or until her office manager caves from harassment.