FM and MPS are two different clinical conditions that require different treatment plans. FM is a systemic disease process, apparently caused by dysfunction of the limbic system and/or neuroendocrine axis. It often requires a multidisciplinary treatment approach including psychotherapy, low dose antidepressant medication and a moderate exercise program. MPS is a condition that arises from the referred pain and muscle dysfunction caused by TrPs, which often respond to manual treatment methods such as ischemic compression and various specific stretching techniques. Both of these conditions are seen routinely in chiropractic offices; therefore, it is important for field practitioners to understand these distinctions.