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Fibromyalgia syndrome (FS) and myofascial pain syndrome (MPS) are currently fashionable diagnoses, despite the lack of objective markers. Although MPS is more often diagnosed by neurologists (particularly those working in pain clinics), FS may ultimately have more significance for neurologists and the medical profession as a whole because of its link to ``chronic fatigue syndrome'' and its ascendance as a legal entity, deemed ``post-traumatic fibromyalgia syndrome.'' Presently, neurologists are only viewing from a distance the milking of this ``cash cow'' by certain rheumatologists and attorneys.
FS is a systemic condition of generalized pain, diagnosed by the assessment of a discreet number of ``tender points.'' On the other hand, MPS enthusiasts are fond of diagnosing the ``trigger point,'' which differs from its cousin because palpation of a trigger point may lead to referred pain elsewhere. Additionally, MPS advocates believe in other phenomena associated with trigger points, such as ``taut bands'' or ``nodules,'' ``local twitch responses,'' and so on. Also, MPS is not considered to be associated as often with other symptoms as is FS, including sleep disturbance, chronic fatigue, and irritable bowel syndrome.
Myofascial pain syndrome.
Beginning.
MPS had its beginning in 1942 when Washington, D.C. internist Janet Travell published her first paper on what would be later known as MPS. In 1983, she combined forces with a colleague, California physiatrist David Simons, writing a two-volume tome entitled, Myofascial pain and dysfunction: The trigger point manual. [1] This became a veritable ``bible'' among many physiatrists, as well as some neurologists, anesthesiologists, chiropractors, and dentists. It has generally gone unchallenged by orthodox practitioners. The strange characteristics of this unusual work are described elsewhere. [2]
Nonreproducibility.
An important study was published by believers in MPS in 1992, which is potentially devastating to the field. [3] They deserve some credit for submitting their examination techniques to scientific scrutiny, which …
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