Table of Contents
- What is Fibromyalgia?
- What is Myalgia?
- Key Differences Between Them
- Treatment Approaches
- Managing Muscle Pain
“Myalgia” refers to muscle pain. Still, there is a distinct difference between the systemic disorder fibromyalgia and myalgia, which can be localized or a generalized symptom of fibromyalgia. The differences include factors such as the cause, location, and duration of the pain. There is still much to learn about both the causes of fibromyalgia and generalized myalgia, and each treatment approach is customized to meet the patient’s pain experience.
What is Fibromyalgia?
Fibromyalgia is not just a condition of muscle pain, but a complex chronic pain disorder believed to be the result of central nervous system (CNS) dysregulation in processing pain. Brain scans have found that people with fibromyalgia have altered signaling in the brain that affects the transmission and receipt of pain signals, highlighting the intricate nature of this disorder.
Though not considered an inflammatory disorder, fibromyalgia has been linked to inflammation in recent studies. People with fibromyalgia have been found to have:
- Elevated concentration of the cytokines that promote inflammation
- Immune response dysregulation
- Neuroinflammation
The research theory is that chronic low-grade inflammation may act as a catalyst for sensitizing pain signaling. This makes the symptoms of fibromyalgia, like myalgia, worse.
It is the widespread pain that meets the American College of Rheumatology’s criteria that identifies whether it is fibromyalgia pain. Fibromyalgia is difficult to diagnose, so the established criteria established a type of measurement. The fibromyalgia symptoms that lead to a diagnosis include the following.
- Pain is experienced on the body’s left and right sides and above and below the waist.
- Pain is present in 11 of 18 tender point sites when the points are palpated.
- The widespread pain index is equal to or greater than seven, and the symptom severity scale score is equal to or greater than five; or the widespread pain index is on a scale of 3-6, and the symptom severity is equal to or greater than nine.
Chronic widespread pain is the main symptom for diagnosis, but the fibromyalgia symptoms that patients experience include more than pain throughout the body.
- Fatigue
- Cognitive dysfunction (fibro fog)
- Sleep disturbances
- Muscle and joint stiffness
- Tenderness when touched
- Legs or arms experience tingling or numbness
- Digestive issues like constipation or bloating
- Sensitivity to the environment, i.e., noise, light, odors, temperature, etc.
What is Myalgia?
Myalgia is a term used to describe pain in a single muscle or a group of muscles. It may exist without fibromyalgia as muscle pain. In this case, the causes of myalgia are usually muscle overuse, strain, infection, or tension.
There are other causes of myalgia. It can be a symptom of muscle diseases (metabolic or inflammatory), muscular dystrophies (genetic disorders), and myotonic muscle disorders (characterized by delayed muscle relaxation after contraction).
Chronic generalized myalgia is still not fully understood, but it can be a symptom of fibromyalgia, meaning fibromyalgia and myalgia can overlap. Some of the people most susceptible to developing chronic myalgia are those with an inflammatory disease like rheumatoid arthritis and lupus.
Some of the myalgia symptoms include:
- Muscle pain that is localized or widespread, if overlapping a disease or disorder
- Muscle tenderness
- Reduce the range of motion
- Muscle weakness
- Fatigue
- Muscle spasms or twitching
- Inflammation at the location of an injured muscle
Key Differences Between Fibromyalgia and Myalgia
Pain from a muscle strain or overuse is not difficult to diagnose. Periodic or chronic myalgia as a fibromyalgia symptom is more challenging because of the complexity of the fibromyalgia disorder.
- Fibromyalgia pain is throughout the body, while myalgia can be localized muscle pain or generalized myalgia pain.
- Fibromyalgia has multiple symptoms, while a myalgia symptom can be limited to pain in one or more specific muscles.
- Fibromyalgia is a pain disorder, while myalgia is a symptom of fibromyalgia.
- Myalgia often results from a muscle injury, overuse, or tension without the presence of a disease or disorder.
- Fibromyalgia is characterized by tender points at various locations on the body, while myalgia pain can be localized and not related to tender points.
- Fibromyalgia is a chronic disorder, while myalgia may be acute or chronic.
Treatment Approaches
There is no cure for fibromyalgia, and so much more needs to be learned about this disorder through ongoing research. Since fibromyalgia is a chronic, widespread disorder, it requires a holistic treatment approach that addresses psychological and physical health. The treatment focus is currently on relieving the symptoms. The doctor may include the following in a holistic treatment plan.
1. Medications
The doctor may prescribe pain-relieving drugs. Anti-seizure medications can reduce pain, improving sleep. Antidepressants are prescribed in some cases because they modulate the neurotransmitters that influence pain, mood and sleep.
2. Cognitive behavioral therapy
This therapy helps patients change their perception of pain to take better control. Psychological therapies include mindfulness, biofeedback, behavioral treatment, and relaxation therapy.
3. Exercise
Researchers are still investigating the impact of exercise on fibromyalgia symptoms, but it is believed that it could reduce pain and fatigue. Aerobic exercises improve muscle oxygenation and the release of endogenous opioids. Aquatic physiotherapy in a heated pool may improve function and reduce pain. Qi Gong involves meditative movements that focus on the mind-body connection. There is evidence that yoga and Tai Chi may improve fibromyalgia symptoms.
4. Diet
Some foods may help reduce symptoms of systemic inflammation. They include olive oil and grains rich in minerals like magnesium and potassium.
5. Supplementation
There are small studies demonstrating that certain supplements may help alleviate pain. They include Chlorella green algae, acetyl-L-carnitine, coenzyme Q10, freeze-dried aloe vera gel, and vitamins C and E.
6. Massage
Treatments of massage-myofascial release may also improve pain, physical function, and anxiety. Muscles are relaxed and circulation improved.
7. Spa therapy
Spa therapies include hydrothermal treatment, contrast therapy with warm and cold water, and physiotherapy. A study found that a group receiving spa therapy for six months experienced significant positive impacts, like reduced pain.
Myalgia is usually treated with a combination of treatments. They include:
- Resting the painful or injured muscle
- Alternating ice and heat therapy
- Doing low-impact exercises
- Physical therapy to improve muscle function
- Massage to release muscle tension
- TENS (transcutaneous electrical nerve stimulation)
- Medications, i.e., NSAIDS, muscle relaxants, corticosteroids, antidepressants for neuropathic pain, etc.
If particular muscles are experiencing treatable pain, a pain specialist may offer specific treatments. They include trigger point injections and peripheral nerve blocks. A pain management specialist will adapt the treatment plan to the patient’s needs.
Managing Muscle Pain
Pain management through targeted treatments for fibromyalgia and myalgia is essential to maintaining a quality of life, whether managing the systemic pain of fibromyalgia or myalgia as localized muscle pain due to injury or strain, or as a symptom of fibromyalgia. There is a lot more research needed on fibromyalgia, but a pain management specialist has many treatment options available to address each person’s unique needs. It is important to consult a healthcare professional for an accurate diagnosis to determine if the pain is due to fibromyalgia, myalgia, or both.
Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11853252/
- https://primarycarenotebook.com/pages/rheumatology/american-college-of-rheumatology-acr-criteria-for-the-classification-of-fibromyalgia
- https://www.niams.nih.gov/health-topics/fibromyalgia
- https://pubmed.ncbi.nlm.nih.gov/31590993/
- https://www.niams.nih.gov/health-topics/fibromyalgia/diagnosis-treatment-and-steps-to-take
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11201510/#sec2-biomedicines-12-01266