FIBROMYALGI OG MYOPHASAL PAIN SYNDROME

Fibromyalgi og myofascial smertsyndrom går ofte hånd i hånd. På grunn av hyppig overlapping og noen lignende symptomer, blir de ofte forvekslet med de samme forholdene, og som følge av dette blir personer med begge noen ganger bare diagnostisert og behandlet med en.

Sondringen mellom myofascial smertsyndrom (MPS) og fibromyalgi (FMS) er en grunnleggende for tre hovedårsaker:

De krever en annen behandling.

Du kan eliminere triggerpunktene.

MPS-smerte kan forverre FMS, og MPS-behandlingen kan berolige FMS.

Noen forskere bruker navnet “kronisk myofaskial smerte” (CMP) i stedet for myofascial smertsyndrom på grunn av bevis på at det er en sykdom, ikke et syndrom. (Et “syndrom” er et sett med symptomer uten kjent årsak.)

Hva er Myofascial Pain Syndrome?

I MPS utvikler muskler og bindevev (som utgjør fascia) det som kalles et triggerpunkt (TRP). (Disse er ikke de samme som de følsomme punktene i FMS.) Et utløserpunkt er en liten, hard knute som noen ganger kan føles under huden. Knuten i seg selv kan være smertefull, spesielt når den er prikket, men forårsaker ofte smerte i et annet område, som kalles referert smerte.

Aktiveringspunktene dannes vanligvis som et resultat av vevstrauma. Eksperter vet ikke hvorfor skaden som normalt herdes hos de fleste, forårsaker PG i andre. Studier tyder imidlertid på at muskeltrauma hos noen mennesker fører til misdannelser der nerveceller kobles til muskelceller. Dette antyder at MPS er en nevromuskulær sykdom.

Hvorfor Fibromyalgi og Myofascial Smert syndrom går sammen

Hvorfor folk med MPS ofte utvikler FMS, er det ennå ikke klart, men en voksende kropp av bevis viser at kronisk smerte kan gjøre endringer i sentralnervesystemet, noe som fører til sentral sensibilisering. Men ikke alle mennesker med MPS utvikler FMS. Hvis teoriene er riktige, kan tidlig behandling av MPS bidra til å forhindre FMS.

Et generelt begrep som kommer fra FMS, MPS og andre sykdommer relatert til sentral sensibilisering er sentrale følsomhetssyndromer.

 

Symptomene på myofascial syndrom og fibromyalgi smerte

Noen av symptomene knyttet til MPS ligner symptomene forbundet med FMS, mens andre ser ut til å være forskjellige. Symptomene som de har til felles er:

Myke smerter varierer fra mild til alvorlig

Hodepine og / eller migrene

Søvnforstyrrelser

Problemene med balanse og / eller svimmelhet

Tinnitus (ringe i ørene) og øre smerte

Minneproblemer

Uforklarlig svetting

Forverring av symptomer på grunn av stress, endringer / ekstremer i klima og fysisk aktivitet

Symptomene knyttet til PMS, men ikke med FMS er:

Nummenhet i ekstremiteter

Klikk eller klikk ledd

Begrenset bevegelsesområde i leddene, spesielt kjeften

Se doble eller uskarpe

Uforklarlig kvalme

Symptomer knyttet til FM, men ikke med MPS, inkluderer:

trøtthet

Panikkanfall

Han føler seg overveldet av de høye nivåene av sensorisk informasjon

Allergier og følsomheter

Avisforvirring og desorientering

Diagnosen Myofascial Painsyndrom

Den angitte smerten gjør MPS spesielt vanskelig å diagnostisere og behandle. Vanligvis sier legen: “Hvor går det vondt?” Og så se hvor du peker. For behandling av MPS må du og legen din undersøke symptomene dine og finne ut hvor utløserpunktene dine er.

Legen din kan finne utløsingspunkter ved berøring eller basert på symptomer. Test som magnetisk resonanselastografi og vevbiopsi kan vise abnormiteter i TrPs, men deres rolle i diagnosen MPS er fortsatt uklart.

Tvert imot er det ingen test eller analyse som avslører abnormiteter i vevet der personer med fibromyalgi opplever smerte.

 

Behandlingen av myofaskial smertesyndrom

Du har flere muligheter for behandling av MPS:

Injeksjonspunkt for bøyning: Legen legger inn en nål direkte inn i en PRO eller flere steder rundt løsningen av de stramme båndene. Legen kan injisere medisin for å lindre smerter, som kortikosteroider eller lidokain. (Merk: Noen leger mener at kortikosteroider kan forverre symptomene på fibromyalgi.)  Når det ikke brukes medisiner, kalles det tørrnål.

Akupunktur: Akupunktur er en gammel kinesisk praksis som ligner på tørrnål. Mens studier av bruken i MPS er begrensede, er de lovende, og mange pasienter og leger rapporterer gode resultater.

Terapi: En spesiell type terapi kalt spray og strekning er vanlig for behandling av MPS. En fysioterapeut guider deg gjennom tøyningsøvelser under påføring av et stoff av en bedøvelse inn i muskelen. Terapeuten kan også bruke noen massasje teknikker for å slappe muskler og TRPS.Además, kan en terapeut jobbe med deg på faktorer som dårlig holdning kan bidra til MPS.

Drugs: Vanlige legemidler for MP’er omfatter steroide antiinflammatoriske legemidler (NSAIDs), t aleve (naproxen) eller ibuprofen-baserte medikamenter så som Advil og Motrin, og trisykliske antidepressiva som amitriptylin, nortriptylin og doxepin.

MPS Behandlinger Behandlinger mot FMS

Igjen er det en viss overlapping, men også viktige forskjeller. Behandlingene som brukes for både MPS og FMS er:

akupunktur

Fysisk terapi (selv om det på forskjellige måter)

Tricykliske antidepressiva (selv om SSRI / SNRI-antidepressiva er stadig vanlig for FMS)

Studier viser utløser punktinjeksjoner er ikke effektive for å lindre følsomme punkter av fibromyalgi, og NSAID er ikke effektive i behandlingen av FMS smerte, siden målrettet betennelse og FMS ikke er kjent som en inflammatorisk tilstand.

 

Lever med fibromyalgi og myofascial smerte syndrom

Med betydelige forskjeller i symptomer, diagnose og behandling, er det klart at fibromyalgi og myofascial smerte syndrom ikke er den samme tilstanden. Som noen som har begge, vet jeg imidlertid at det kan være ekstremt vanskelig å avgjøre hvilken tilstand som forårsaker smerten.

Ved å arbeide både på egen hånd og med legen din og / eller fysioterapeut, kan du kanskje finne ut hvor du har utløserpunkter og den beste måten å behandle dem uten å forverre fibromyalgi. Alleviating myofascial smerte er sannsynligvis å berolige dine fibromyalgi symptomer, så du kan godt se en dobbel fordel.

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