Devin's Diagnostic
(This is adapted from "The Fibromyalgia Advocate", 1998, © Devin J. Starlanyl)
It isn’t unusual to have both TrPs and FMS contributing to one
symptom — sometimes with the addition of reactive hypoglycemia (RHG) or insulin
resistance (IR). Some of your symptoms may be caused by the side effects of medications.
There are other medical conditions that can cause some of these symptoms as well.
This
guide will, however, indicate whether there is a pattern to your symptoms.
For example, if
you have three symptoms indicating possible TrPs, you have a great likelihood of having
other symptoms also caused by TrPs and a good possibility of having chronic myofascial
pain. Visual locations of TrPs and their reference zones can be seen in the video
"Chronic Myofascial Pain Syndrome: The Trigger Point Guide" (see
video).
Key to Understanding the Self-Diagnostic Guide
"(FMS)" indicates that the preceding symptom often
accompanies fibromyalgia. "(H)" indicates that reactive hypoglycemia or insulin
resistance may contribute to the symptom. The Latin-derived names of the muscles in
brackets [ ] indicate the most likely muscles that may have TrPs that could cause the
symptom. The symptoms are listed in boldface type, but by design, they are not in any
particular order. There may be a variety of causes for every symptom, and there are many
ways of categorizing the symptoms. I do not wish to imply connections where there may not
be any, nor, by separating symptoms, to exclude them where they may exist.
Each of us is
different and our patterns of symptoms may be different.
Symptom List and Possible Causes
Childhood growing pains:
[early TrPs]
"Traveling" nocturnal sinus stuffiness: [pterygoid,
sternocleidomastoid, posterior digastric]
Allergies: (FMS)
Post nasal drip: (FMS), [pterygoid, sternocleidomastoid]
Drooling in sleep: [internal medial pterygoid]
Swollen glands: [digastric]
Difficulty swallowing: [digastric, pterygoid]
Dry cough: [lower end sternal sternocleidomastoid]
TMJ symptoms: [masseter, trapezius, temporalis, pterygoid]
Dizziness when turning head or changing field of view:
[sternocleidomastoid], (H)
Runny nose: (FMS), [sternocleidomastoid, pterygoid]
Sore throat: [sternocleidomastoid, digastric, pterygoid]
Stiff neck: [levator scapulae]
Mold/yeast sensitivity: (FMS), (H)
Reflux esophagitis: [external oblique], (H)
Headaches/migraines: (FMS), [trapezius, sternocleidomastoid, temporalis,
splenii, suboccipital, semispinalis capitis, frontalis, zygomaticus major, cutaneous
facial, posterior cervical], (H)
Light and/or broken sleep pattern with unrefreshing sleep: (FMS)
Sweats: (FMS), (H)
Morning stiffness: (FMS), [multiple TrPs]
Fatigue: (FMS), [multiple TrPs], (H)
Shortness of breath: (FMS) [serratus anterior, diaphragm, other
respiratory muscles], (H)
Painful weak grip that may let go: [infraspinatus, scaleni, hand
extensors, brachioradialis]
Menstrual problems and/or pelvic pain: (FMS), [coccygeus, levator
ani,
obturator internus, high adductor magnus, abdominal obliques]
PMS: (FMS)
Loss of libido: (FMS)
Low back pain: [quadratus lumborum, thoracolumbar
paraspinals, longissimus, ilicostalis, multifidi, rectis abdominis]
Nail ridges and/or nails that curve under: (FMS)
Difficulty speaking known words: (FMS), (H)
Directional disorientation: (FMS), (H)
Visual perception problems: [sternocleidomastoid], (H)
Tearing/reddening of eye, drooping of eyelid: [upper sternal
sternocleidomastoid]
Loss of ability to distinguish some shades of colors: (FMS)
Short-term memory impairment: (FMS), (H)
Weight gain/loss: (FMS), (H)
Sensitivity to odors: (FMS)
Mitral valve prolapse: (FMS)
Double/blurry/changing vision: [internal eye muscles, temporalis,
sternocleidomastoid, trapezius, cutaneous facial, splenius cervicis]
Visual and audio effects/falling sensations before sleep (called "sleep
starts"): (FMS)
Earaches/ringing/itch: (FMS), [SCM, masseter, pterygoid],
Unexplained toothaches: [temporalis, masseter, digastric]
Rapid/fluttery/irregular heartbeat/heart attack-like pain: (FMS),
[sternalis, pectoralis], (H)
Bloating/nausea/abdominal cramps: (FMS), [abdominals,
multifidi,
iliocostalis, paraxiphoid rectus abdominus, quadratus lumborum, upper thoracic
paraspinals], (H) [Note: for excessive gas and belching, check for TrP at angle of 12th
rib, either side.]
Appendicitis-like pains: [iliopsoas, rectus abdominis, piriformis,
iliocostalis]
Carbohydrate/chocolate cravings: (FMS), (H)
Sensitivity to cold/heat/humidity/pressure changes/light/wind: (FMS)
Abdominal cramps, colic: [periumbilical rectus abdominus]
Panic attacks: (FMS), (H)
Mottled skin: (FMS)
Depression: (FMS), (H)
Confusional states: (FMS), (H)
Thumb pain and tingling numbness: [brachialis entrapment of radial nerve,
adductor pollicus]
Urine retention: [upper pubic, inguinal ligament, lower internal oblique
and lower rectus abdominus TrPs]
Tendency to cry easily: (FMS), (H)
Night driving difficulty: (FMS)
Weak ankles: [peroneus, tibialis]
Lax, pendulus abdomen: [abdominal TrPs, especially in rectus
abdominus]
Upper/lower leg cramps: [sartorius, gastrocnemius]
Tight Achilles tendons: [tibialis posterior]
Groin pain: [adductores longus and brevis, iliopsoas]
Irritable bowel: (FMS), [pelvic TrPs,
multifidi, high
adductor magnus, abdominal obliques], (H)
Sciatica: [thoracolumbar paraspinals, gluteus
minimus, hamstrings,
piriformis, iliopsoas]
Urinary frequency: (FMS), [cutaneous and myofascial lower abdominal TrPs]
Impotence: (FMS), [piriformis pudendal nerve entrapment]
Stress incontinence, anal/genital/perineal pain: [pelvic floor TrPs, high
adductor magnus, piriformis, paraspinals]
Painful intercourse: [vaginal TrPs, pelvic floor TrPs, piriformis]
Muscle twitching: (FMS), [local TrPs]
Numbness and tingling: [nerve entrapment by TrPs]
Diffuse swelling: (FMS), [vascular entrapment by TrPs]
Hypersensitive nipples/breast pain: [pectoralis]
Fibrocystic breasts: (FMS), [possible ductile entrapments by TrPs]
Buckling knee: [vastus medialis, quadriceps, adductor
longus]
Problems climbing stairs: [sartorius, quadriceps femoris, vastus
medialis]
Problems going down stairs: [popliteus]
Free-floating anxiety: (FMS), (H)
Mood swings: (FMS), (H)
Unaccountable irritability: (FMS), (H)
Trouble concentrating: (FMS), (H)
Shin splint-type pain: [peroneus, tibialis]
Heel pain: [soleus, quadratus plantae, abductor hallucis, tibialis
posterior]
Sensory overload: (FMS), (H)
Handwriting difficulties: [adductor/opponens pollicis]
Sore spot on top of head: [splenius capitis, sternocleidomastoid]
Problems holding arms up (as when folding sheets): [subscapularis,
infraspinatus, supraspinatus, upper trapezius, levator scapulae]
"Fugue"-type states (staring into space before brain can function):
(FMS), (H)
Tight hamstrings: [hamstring complex, adductor magnus, quadriceps
femoris, iliopsoas, gastrocnemius] Numbness/tingling on the outer thigh (meralgia
paresthetica): [quadriceps femoris, vastus lateralis, sartorius, tensor fascia latae
entrapment]
Carpal tunnel-like pain in wrist (watchband area): [subscapularis]
Balance problems/staggering gait: [sternocleidomastoid, gluteus
minimus],
(H)
Restless leg syndrome: [gastrocnemius, soleus]
Myoclonus (muscle movements and jerks at night): (FMS), [local TrPs]
Feeling continued movement in car after stopping: [sternocleidomastoid]
Feeling tilted when cornering in car: [sternocleidomastoid]
First steps in the morning feel as if walking on nails: [long flexors of
toes, tibialis posterior]
Pressure of eyeglasses or headbands is painful: [head, neck and shoulder
TrPs]
Thick secretions: (FMS)
Bruise/scar easily: (FMS)
Some stripes and checks cause dizziness: [sternocleidomastoid]
Bruxism (teeth grinding): (FMS), [digastric, masseter,
soleus]
Inability to recognize familiar surroundings: (FMS), (H)
Delayed reactions to "overdoing it": (FMS)
Family clustering (other members of the family have FMS): (FMS)
Tissue overgrowth (fibroids, ingrown hairs, heavy and splitting cuticles,
adhesions): (FMS)
