Fibromyalgia syndrome (FMS) is a syndrome characterized by pain radiating particularly to the neck, shoulder, back and waist regions through trigger points located in the palpable taut muscle band. This syndrome, which is very common in the community, is one of the most common causes of musculoskeletal pain. Although it is more common in women, it affects both sexes. It is reported that it is more common between the ages of 30-40.
Although the cause is not known exactly, abnormalities in the patient’s body posture may trigger pain. In particular, structural abnormalities such as increased cervical or lumbar lordosis, scoliosis, poor head position, and jobs that affect posture can cause FMS. The pain may be continuous or intermittent. It intensifies when the trigger touches the point. When the trigger point is palpated, the pain is either in the trigger point area or radiates to distant areas. Each muscle has its own pain pattern of trigger points. From this pain distribution, it can be determined to which muscle the relevant trigger point belongs. There may be tenderness, limitation of range of motion, and/or general fatigue along with pain. Patients state that their complaints increase with fatigue, cold weather, excessive exercise, inactivity, emotional tension, and their complaints decrease with heat, relaxation, massage, slight stretching of the muscles and aerobic exercises.
The first step in treatment is to make a correct diagnosis. Once the correct diagnosis is made, there are many options for treatment. Purposes of FMS treatment; pain relief, adequate muscle strength and full range of motion.
Dry needling (acupuncture); It is one of the methods used in the treatment of FMS. The needle acts by mechanically disrupting the sensory or motor components of abnormally functioning muscles. It initiates the healing process in that area by causing the trigger point damage. In previous studies, it was stated that dry needling is a very effective method in myofascial trigger point inactivation.
Trigger point injection is another effective method in FMS. It is the process of injecting local anesthetic or Botox with fine needles into painful points. In the trigger point injection performed with local anesthetic, the patient feels a quick relief, 4-5 sessions are sufficient. Botox injection can also be applied for longer-term relief. In addition, physical therapy methods, relaxation exercises, antidepressant drug therapy, muscle relaxants and simple pain relief agents can also be applied in the treatment.
