Chronic pain refers to pain which lasts for over three months, even when any initial injury or illness has passed. There are lots of conditions which cause chronic pain. Each condition comes with its own set of symptoms and ways it can affect the diagnosed individual.
Both fibromyalgia and chronic pain syndrome are common diagnoses. We’ll take a closer look at what they are and the differences between the two conditions.
What is Chronic Pain Syndrome?
You might hear the term “chronic pain syndromes” used as an umbrella term to refer to all chronic pain conditions. This can make it a bit confusing, but chronic pain syndrome can also be used as a diagnosis in itself.
Chronic pain syndrome (CPS) refers to ongoing chronic pain which also leads to additional symptoms that interfere with daily functioning. In particular, it leads to emotional and mental health issues which make the experience of living with chronic pain harder.
So essentially, chronic pain may be referred to as CPS if it impacts your life and mental health significantly. Unfortunately, the exact definition of CPS is hard to pin down and can vary when it comes to the details.
This 2020 article from Doctor Manish K Singh explains that: “CPS is a poorly defined condition.” He goes on to state: “Most authors consider ongoing pain lasting longer than 6 months as diagnostic, and others have used 3 months as the minimum criterion.”
CPS is usually caused by another health issue or an injury. Even when the other issue is resolved, the pain can continue because the body has ‘learnt’ to keep producing pain signals.
This 2023 article from the National Library of Medicine explains that CPS can be caused by: “physical or psychological trauma(accident, death of a loved one), an infectious process such as Ebstein Barr virus (EBV), chronic underlying diseases such as sickle cell anaemia or autoimmune conditions, or it can occur in the setting of multiple episodes of acute pain.”
In addition to pain, symptoms of CPS can include:
- Issues with sleep
- Feeling tired and drained
- Social issues, such as isolation and the breakdown of relationships
- Irritability and frustration
- Aching muscles
- Loss of mobility
- Joint stiffness and pain
This article explains that “About 25% of people with chronic pain will go on to have a condition called chronic pain syndrome (CPS).” Anyone can have CPS but it’s more common in people assigned female at birth, those who smoke, people who have depression, and those who are older than 65. It’s usually diagnosed after a series of tests and examinations.
CPS can be in one area of the body or multiple areas. In some resources it is also referred to as chronic noncancer pain (CNCP), simply meaning chronic pain that isn’t related to cancer or cancer treatment.
What is Fibromyalgia?
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) describes fibromyalgia as: “a chronic (long-lasting) disorder that causes pain and tenderness throughout the body, as well as fatigue and trouble sleeping.” Fibromyalgia can also cause a wide range of other symptoms.
Some of the main symptoms include:
- Widespread pain (in multiple areas of the body)
- Joint and muscle stiffness or tension
- Hyperalgesia – people with fibromyalgia are more sensitive to painful stimuli (they feel pain more intensely)
- Allodynia – sensitivity to touch (touch that shouldn’t cause pain can be very painful)
- ‘Fibro fog’ – problems with thinking, memory, and concentrating
- Sensitivity to light, sound, noises, and temperature
- Digestive issues – many people with fibromyalgia also have irritable bowel syndrome (IBS)
- Dizziness and balance issues
- Paraesthesia – feelings of tingling, burning, and numbness
Symptoms can vary in severity and type, which makes the condition unpredictable and complex to manage. The condition can vary greatly from one person to the next, so diagnosis can be challenging and is typically a process of elimination.
Scientists don’t know the exact cause of fibromyalgia, but it’s thought to be a problem with how the body sends and receives pain signals. Essentially, the nervous system isn’t communicating properly and is causing pain signals to be sent even when there’s no danger. The nervous system is on high alert, which is also known as central sensitization.
Symptoms often develop after physical or emotional trauma but can occur with no known trigger. The condition is more common in people assigned female at birth and tends to run in families. This 2023 systematic review and meta-analysis states that: “80%–90% of the affected individuals are female”.
First, let’s take a look at the similarities between chronic pain syndrome (CPS) and fibromyalgia. Both conditions cause chronic pain and are thought to involve the nervous system mistakenly producing pain signals. They can both cause issues with functioning and impact quality of life.
The experience of living with CPS and fibromyalgia and the challenges patients face are alike in many ways. Both conditions are more common in people assigned female at birth and can be present in people of all ages.
Stigma is common with both conditions because symptoms can be so varied depending on the individual. Most of the symptoms are invisible, so people (medical professionals included) often don’t believe the patient. Symptoms are also highly changeable in both diagnoses and can vary in severity from day to day, or even by the hour!
One person can even have both conditions, which can make diagnosis difficult. Both conditions have very similar treatment approaches and can be managed in similar ways.
Despite overlapping symptoms and the experience of living with both diagnoses being very similar, there are distinct differences between the two.
Chronic pain syndrome (CPS) usually occurs due to an illness, injury, or another health issue affecting how the body functions. However, fibromyalgia can occur without the presence of an obvious trigger.
CPS results from a physical problem with the nerves or other areas of the body, while with fibromyalgia there’s no damage to the nerves or body. Instead, there’s a problem with how the nervous system functions. Therefore, with chronic pain syndrome often damage will show up on tests, while with fibromyalgia tests tend to come back clear unless the patient has additional diagnoses.
This also means that the diagnostic process for the two conditions varies slightly. CPS may be diagnosed if damage or other health conditions are shown on tests. While fibromyalgia is diagnosed when other conditions have been ruled out.
CPS can be hard to define, with some experts referring to it as a singular condition and others using it as an umbrella term. This 2020 article states that CPS sometimes refers to a: “constellation of syndromes that usually do not respond to the medical model of care.” On the other hand, fibromyalgia is generally a well-defined diagnosis of a singular condition.
CPS can be in one or two areas of the body while fibromyalgia is categorised by widespread pain, meaning in many areas of the body.
When it comes to symptoms, brain fog and cognitive issues are very common with fibromyalgia but don’t occur often in CPS. Other symptoms such as digestive upset, high pain sensitivity, and sensitivity to touch are typically only seen in fibromyalgia and not CPS.
To summarise, the differences between chronic pain syndrome and fibromyalgia are:
- CPS occurs due to an illness or other health issues – fibromyalgia can occur with no known trigger
- CPS can be a result of physical damage – fibromyalgia doesn’t involve physical damage to the body or nerves
- CPS is diagnosed through tests – fibromyalgia is a process of elimination
- CPS can affect one or more areas of the body – fibromyalgia affects many areas of the body
- CPS doesn’t usually involve cognitive issues – ‘fibro fog’ is very common in fibromyalgia
Treatments for Chronic Pain
Both conditions have the same treatment options, although chronic pain syndrome will involve treatment of the root cause first if you have an illness or injury. Your doctor or specialist should talk you through your options to help you figure out what’s best for you.
Over-the-counter medications that may be recommended include painkillers such as paracetamol and non-steroidal anti-inflammatories (NSAIDs). You can also get topical pain relief, such as creams, roll-ons, gel pads, and patches.
You may be offered prescription medication, such as stronger painkillers, antidepressants, anticonvulsants, or steroids. What you will be offered depends on your symptoms and general health. Many prescription medications have side effects, so it’s important to do your research and ask plenty of questions.
Living with chronic pain takes its toll emotionally and is often linked with mental illness. The mind and body are connected, so one can influence the other.
Mindfulness-based therapies can reduce stress, improve sleep, improve your mental health, and calm your nervous system.
Manual and Physical Treatments
Treatments like physiotherapy and hydrotherapy can help reduce pain and increase mobility. Part of the treatment will often involve the medical professional showing you how to build up movement slowly and safely in a way that works for your body.
Manual treatments like massage can help to reduce pain for some people. There are also treatments which you might hear referred to as ‘complementary or alternative’ treatments. These include acupuncture and chiropractic treatment. Some people find these very helpful although they’re not usually offered by traditional doctors so you will need to do your own research on where to access them.
Pain Management Programmes
You may be referred to a pain management clinic or programme by your doctor. These clinics involve seeing several specialists who may offer pain education, exercises, and a variety of treatments.
You can also access online pain management programmes like Pathways Pain Relief, which you can do in the comfort of your own home.
There are also plenty of things you can do at home to try to reduce pain levels and improve your quality of life. These include:
- Pacing your activity
- Keeping a regular sleep schedule
- Eating healthy meals
- Gentle exercise
- Reducing stress
- Learning about your pain
- Asking for help when you need it
- Using a mobility aid
- Doing things that bring you joy and give you purpose
Of course, a lot of these are easier said than done when you live with chronic pain, but we can try our best to create a routine that works for us.
In my experience, one of the most important things is learning to be kind to yourself. Have patience with yourself and encourage yourself, rather than being hard on yourself.
Which One Do You Have?
It’s difficult to tell which condition you have by just thinking about your symptoms alone. The best way to find out is to visit a medical professional so you can be given tests and a proper diagnosis. No matter which chronic pain condition you have, remember that there is always hope!
- Manish K Singh, MD, Jashvant Patel, MD, MS, Rollin McCulloch Gallagher, MD, MPH, (2020), “Chronic Pain Syndrome”. Medscape.
- Yasaei R, Peterson E, Saadabadi A., (2020), “Chronic Pain Syndrome.” In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
- Stephanie Watson, (2022), “What Is Chronic Pain Syndrome?”. Web MD.
- Álvaro-José Rodríguez-Domínguez, Manuel Rebollo-Salas, Raquel Chillón-Martínez, et al, (2023), “Clinical relevance of resistance training in women with fibromyalgia: A systematic review and meta-analysis”. European Journal of Pain.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), (2021), “Fibromyalgia”. National Institutes of Health