There is a great deal of talk recently about similarities between Fibromyalgia, Hypothyroidism, and Myofascial Pain Syndrome. In fact many people are misdiagnosed because of the number of shared symptoms. Even though many of the same symptoms are present in these three, there are many differences. Fibromyalgia is listed with the Arthritis Foundation as a legitimate disease; therefore a doctor who is knowledgeable in Fibromyalgia should perform its diagnosis. He will consult with the patient and test for the tender points to make sure that at least 11 of the 18 test positive.
Myofascial Pain Syndrome (MPS) is the presence of specific knots and bands in the muscles that you can feel when you press on them. These are called trigger points. Doctors can feel these knots and will consult with the patient to make this diagnosis.
Hypothyroidism displays many similarities to FM and MPS, but a doctor can and should do a blood test to either confirm it or rule it out before diagnosing patients with FM or MPS.
Here are the similarities and differences between Fibromyalgia, Hypothyroidism, and Myofascial Pain Syndrome:
Trigger points (MPS) are known to cause:
- Dizziness, imbalance, nausea, headaches, migraines;
- Neck and jaw pain;
- Low back pain, scoliosis;
- Tennis elbow and symptoms of carpal tunnel syndrome;
- Stiffness and pain in the joints such as knuckles, wrists, elbows, shoulders, knees, and hips can be mistakenly attributed to arthritis, tendonitis, bursitis, or ligament injury;
- Specific muscle weakness;
- Irregular heartbeat, chest, and false heart pain;
- Red eyes, excessive tearing and salivation, blurred vision, droopy eyelid;
- Sore legs and feet; and painful ankles;
- Sinus pain and congestion, persistent nasal secretion;
- Impaired movement and reduced range of motion by keeping muscles short and stiff;
- Impaired coordination, stumbling; and dropping things unexpectedly that can be mistaken for neurological health issues;
- Pelvic pain, pain during intercourse.
Symptoms of Hypothyroidism
- Weight gain or increased difficulty losing weight;
- Coarse, dry hair;
- Dry, rough pale skin;
- Hair loss;
- Cold intolerance (you can’t tolerate cold temperatures like those around you);
- Muscle cramps and frequent muscle aches;
- Memory loss;
- Abnormal menstrual cycles;
- Decreased libido.
Symptoms of Fibromyalgia
- Chronic muscle pain, muscle spasms or tightness, weakness in the limbs, and leg cramps;
- Moderate or severe fatigue and decreased energy;
- Insomnia or waking up feeling just as tired as when you went to sleep;
- Stiffness upon waking or after staying in one position for too long;
- Difficulty remembering, concentrating, and performing simple mental tasks (“fibro fog”);
- Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome);
- Tension or migraine headaches;
- Jaw and facial tenderness;
- Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold;
- Feeling anxious or depressed;
- Numbness or tingling in the face, arms, hands, legs, or feet;
- Increase in urinary urgency or frequency (irritable bladder);
- Reduced tolerance for exercise and muscle pain after exercise;
- A feeling of swelling (without actual swelling) in the hands and feet;
- Painful menstrual periods;
To help further explain, the following chart shows the clinical difference between the trigger points in MPS and the tender points in FM.
Tender points/ Fibromyalgia
- Cause only local pain but can increase general body sensitivity to pain.
- Pain on touch.
- Dysfunction of central nervous system with generalized disturbance of how pain is processed. No palpable or pathological evidence that muscular fiber is involved.
- No measurable electrical signals.
- Cannot be seen.
- Are located at 18 specific points of the body.
- On average temperature is 0.65 grad C lower than in trigger points.
- No muscle weakness.
- Muscle can be strengthened.
Trigger points/Myofascial Pain Syndrome
- Cause referral pain.
- Need firm pressure to elicit pain.
- Musculoskeletal condition. Palpable knots or small lumps in the skeletal muscle fibers.
- Emit distinctive electrical signals that can be measured.
- Can be photographed in muscle tissue using electron microscope.
- Anywhere in the body and always occur at the midpoint of the skeletal muscle fibers.
- Higher temperature due to increased metabolic activity.
- Muscle weakness.
- Muscle strengthening makes condition worse.
Because these conditions are so close in the symptoms they share, it is very important to make sure to rule out each of them before making a clear diagnosis. You must find a doctor knowledgeable in Fibromyalgia, Hypothyroidism, and Myofascial Pain Syndrome. This might mean that you will have to go to several doctors.
Your primary care doctor is the best place to start. Be sure to ask him all your questions. Keeping a journal of the times of day your pain is higher and what you were doing when the pain increased will be a great help to your doctor. It would also be a good idea to bring a list of specialists that you would like to see.
In relation to the thyroid, it’s best to have blood work done by a doctor knowledgeable in Endocrinology. Their testing is more in-depth because they specialize in this area. Dr. Anita Chaudhuri in Niagara Falls, New York, is highly recommended endocrinologist, and a good choice of pain doctor is Dr. Romanth Waghmarae in Williamsville, New York.
There are many other good doctors in western New York, so ask friends, co-workers, and family members if they can make any suggestions. Get the right diagnosis so you can get the right treatment and begin to feel better.
The Arthritis Foundation
References for this article came from:
The trigger point therapy workbook: Your self-treatment guide for pain relief by C. Davies, D.G. Simons, A. Davies, New Harbinger Publications, 2004
Myofascial pain and dysfunction. The trigger point manual. Volume 2. The lower extremities by D.G. Simons, J.G. Travell, Lippincott Williams & Wilkins, 1992
Myofascial pain and dysfunction. The trigger point manual. Volume 1. Upper half of body by D.G. Simons, J.G. Travell, L.S. Simons, Lippincott Williams & Wilkins, 1999