A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management.

Two prominent forms of chronic musculoskeletal pain disorders are fibromyalgia (FM) and myofascial pain syndrome (MPS). Inconsistent diagnosis of chronic musculoskeletal pain is an important clinical issue, as MPS is often mistaken for FM. Distinction between the two diagnoses depends largely on identification of either tender points or myofascial trigger points in FM and MPS, respectively. However, there currently is no standard diagnostic protocol for MPS. Consequently, this results in a lack of consistency across health care practitioners diagnosing both FM and MPS. Therefore, developing sensitive and reliable mechanism-based diagnostic criteria is imperative to the field of musculoskeletal pain. The focus of this review is to discuss the common and unique features of FM and MPS in the context of their epidemiology, clinical features, and pathophysiology. This review will address inconsistency among health care practitioners' diagnoses, and present alternative diagnostic tools with potential for inclusion into a mechanism-based diagnostic protocol.