A fact I think tends to be frequently overlooked or glossed over is that fibromyalgia (FMS) can be either primary, meaning without a known trigger, or secondary, which means we know (or at least have a pretty good idea) why it developed.

While we still don't know exactly what's going on in the body that leads to fibromyalgia, we do know that chronic pain can cause changes in the brain and central nervous system that lead to central sensitization - essentially making the body overreact to pain and other stimuli (noise, smell, bright lights, etc.). That's why it's believed people with rheumatoid arthritis (RA), lupus, multiple sclerosis (MS) and other chronic pain conditions frequently develop FMS.

Why do I bring this up? Because I think it's important to make the distinction when we talk about treatments. For example, I've written here about my success with acupuncture. It could be that I've had amazing success because acupuncture is one of the best treatments for my original condition, which is myofascial pain syndrome (MPS, or CMP for chronic myofascial pain). In fact, that's why I started the treatments. I can't say for sure whether acupuncture relieved my fibromyalgia symptoms directly (some studies show it can), or whether relieving the MPS symptoms had a secondary effect of calming my fibro symptoms.

I probably wouldn't qualify for fibromyalgia drug trials because I have another pain condition that makes it hard to gauge what effect a fibromyalgia treatment is having. The same goes for someone with RA, MS, etc. It makes me wonder if that's part of why medications effect different people so differently. Maybe MPS-related FMS responds differently than primary FMS or RA-related FMS. (Maybe not, but wouldn't it be interesting to know for sure?)

Another reason I think the distinction is important is that some conditions that can lead to fibromyalgia may go undiagnosed, their symptoms lumped blindly in with FMS. My rheumatologist realized I had MPS well after diagnosing my FMS. I've had mild-to-moderate chronic pain, with bouts of severe pain, since I was 10 years old, but no one had ever figured out why. If she'd missed the MPS (like everyone else had), I'd probably be far less functional today.

Do you know if your FMS is primary or secondary? Has treating your other condition helped your FMS? Share your stories here or in About.com's Fibromyalgia & Chronic Fatigue Syndrome forum.

• Conditions that Overlap with Fibromyalgia & Chronic Fatigue Syndrome
• Fibromyalgia vs. Myofascial Pain Syndrome
• Fibromyalgia Symptoms - The Monster List!

After returning from a really great camping trip with my family and some friends, I'm tired. I'm achy. I'm sleeping even worse than usual. And I'm wondering if I could have done a better job of getting myself through it without aggravating my fibromyalgia (FMS).

I was careful, and I tried to be smart. This was the debut of our tent trailer, which my husband worked hard to make comfortable for me (and it is!) We kept meals and clean up as simple as possible, and I tried hard to pace myself. I skipped activities that might take too much energy or put a strain on my bad back and hips.

I made it through the trip with flying colors. The day after getting home, though, the aches and deep fatigue set in, and five days later I haven't been able to shake them. I'm wondering if I could have done something differently, or if this is just the price I have to pay. (If so, I'll still do it again - it was worth it!)

Have you found ways to get through trips without crashing afterward? What works for you? What mistakes have you made that you've suffered for? Share your stories to help us all! You can post your comments here or in About.com's Fibromyalgia & Chronic Fatigue Syndrome forum.

Suggested Reading:

• Coping with Fibromyalgia
• Explaining Fibromyalgia to Friends & Family
• Ouch! It Hurts to Wear Clothes!
• The Fibromyalgia Impact Questionnaire