Am I Having a Heart Attack?
Many people who deal with fibromyalgia syndrome (FMS) have experienced chest pain – sometimes so severe it sends them to the hospital thinking they’re having a heart attack. After the ECG is run and everything comes back normal, confusion sets in. What, exactly just happened? If you have FMS, then it may be one of two things: costochondritis or myofascial pain. The difficult issue with both of these conditions is that the treatment is not conducive to relief from FMS and may even exacerbate FMS symptoms. It really can be a catch-22.
Fibromyalgia and Costochondritis
Fibromyalgia and costochondritis are commonly found together, even though they are really two separate conditions, each requiring its own treatment. However, treatment of costochondritis in an FMS sufferer is important because it can exacerbate the pain of fibromyalgia.
Costochondritis causes pain in the chest that can spread through the ribcage with a sharp and gnawing pain, especially where the ribs meet the breastbone. That is why many people who have an experience with costochondritis think they’re having a heart attack. If you do have FMS and get chest pains, don’t assume it is costochondritis – have it checked out properly to rule out any other issues. It could be heart-related and you may require immediate treatment.
What is Costochondritis and How Do I Treat It?
Costochondritis pain often concentrates on the left side and can become more aggravated with physical activities, like exercise. The pain can radiate out and down your arms. Breathing may become difficult and coughing can create a spasm in your chest because the cartilage must expand to allow for movement. Often, this pain does go away by itself but it can take a while. The suggested treatments for costochondritis include:
· NSAIDs, such as ibuprophen or naproxen
· Antidepressants for sleep disturbances
· Muscle relaxants to spasms
· Rest and avoiding strenuous activities
· Gentle exercise in moderation
· Heating pad
The cause of costochondritis is not clear but some possibilities include chest trauma that may have occurred in a vehicle accident; overuse injuries; upper respiratory infections. Some experts also believe that FMS can be a contributor to costochondritis and often makes the symptoms worse and more painful.
People with FMS have symptoms that are very similar to and consistent with costochondritis, although it is not clear whether is actually is costochondritis because inflammation is not consistent with FMS.
It is possible that the tender points just beneath the collar bone may play a part and myofascial pain syndrome is another possibility.
Fibromyalgia and Myofascial Pain Syndrome
Fibromyalgia and myofascial pain syndrome (MPS) are another pair of conditions that often go together yet are distinct from one another. It is important that the distinction be recognized because they require different treatments.
Although FMS has tender points, MPS has trigger points and these trigger points can be eliminated. Also, MPS pain can make FMS worse, and treating MPS can have a calming effect upon FMS symptoms.
In myofascial pain syndrome, muscles and connective tissues develop trigger points (TrP), which are not the same as tender points found in fibromyalgia. A trigger point is a small, hard knot that you can often feel under your skin.
The knot itself can be painful and it causes referred pain – that is pain in another area. Trigger points are usually the result of some kind of trauma to the tissue in that particular area.
While many people sustain a knock or injury and heal just fine, others develop malformations at the site of the muscle trauma where the nerves connect to the muscles. This is what causes referred pain.
Similar but Different
The FMS/MPS connection isn’t clear. However, there is evidence that chronic pain such as is inherent in FMS can make changes to the central nervous system that results in central sensitization.
Some MPS symptoms are similar to FMS symptoms, such as:
· soft-tissue pain ranging from mild to severe
· headaches or migraines or both
· sleep disturbances
· problems with balance and dizziness
· ear pain
· memory challenges
· experiencing worsening symptoms with weather changes, stress or physical activity
Chest Pain and MPS
Of course, chest pain associated with FMS can be caused by MPS. Chest pain caused by MPS can be relieved through trigger point treatment wherein a doctor inserts a needle directly into a trigger point, or in several places around it.
In the case of chest pain, the trigger point may be under the rib. The insertion of a needle works in a similar way to acupuncture by releasing the taut bands around the knot. Other treatments include methods that can be contra-indicated for FMS.
It is clear that FMS and MPS are different conditions; however, they can be and often are found together in individuals. It is important, therefore, to understand the conditions and know how best to treat them by working together with a good doctor and/or physical therapist.
You may be able to figure out what is causing the pain and take the appropriate action without exacerbating the fibromyalgia.
Learn more about costochondralgia and costochondritis in this article.