Fibromyalgia is characterized by the presence of tender points, but some people find relief with trigger-point therapy, also called myotherapy or myofascial therapy. As you might recall, trigger points are tight, highly irritable spots in a taut band of muscle that can cause referred pain, or pain located away from the trigger point itself.

Many people confuse trigger points and tender points. Trigger points are spastic knots in the muscles that cause pain. Tender points are the spots doctors press to determine if you have fibromyalgia. Virtually everyone has trigger points, though they may not be active.

Since fibro causes increases pain sensitivity, fibro patients are much more sensitive to their trigger points than normal people. The pain caused by the trigger point makes the person tighten her muscles, thereby creating more trigger points around her body in a “brush fire” effect. In many fibro patients, this can be a major part of the pain they're experiencing. That's why trigger-point therapy is helpful.

Trigger-point therapy uses a combination of stretching and deep manual pressure applied to specific trigger points to relax the knotted muscles and break the cycle of pain. It's often combined with heat, ice, cold spray, ultrasound, or electrical stimulation to make it more effective and to encourage the tissue to respond to the treatment.

To treat the affected trigger points, the practitioner applies pressure using fingers, knuckles, and/or elbows to each point for up to thirty seconds. You may initially feel pain from the pressure, but it should never cross the line between “good” pain and “bad” pain. The therapy usually leads to considerable relief.

During treatment, it's very important to tell the therapist if the treatment starts to hurt. Pressure that's too aggressive can activate the trigger point, setting off a spasm and increasing the pain.

In severe cases, trigger-point injections can be added to the treatment. If done by themselves, the effect of injections tends to be more temporary. Though some doctors still put steroid medications in the shots, this generally is not recommended. Steroids provide minimal additional benefit and can cause side effects.

It's also very important to have your practitioner teach you how to treat yourself. Myofascial self-care, done twice a day, can dramatically increase your rate of improvement and gives you some control over your own pain. Eventually, you can become good enough at it that you won't need another person to do it for you.