Chronic muscle pain (myalgia) is a common problem throughout the world.
Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain.
The two common muscle pain conditions are Fibromyalgia and Myofascial Pain Syndrome.
Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis.
Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle.
The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying causes of persistent or chronic muscle pain in order to develop a specific treatment plan.
Chronic myalgia may not improve until the underlying precipitating or perpetuating factors are themselves managed.
Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypo-mobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency.
Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition. Continue reading Treating Chronic Muscle Pain by Robert Gerwin