Fibromyalgia: How Physical Therapy Can Help
Fibromyalgia is a chronic pain condition that affects nearly five million Americans, 80 to 90% of whom are women. While the cause of fibromyalgia is unknown, it is thought to be due to changes in the way the nervous system processes pain. When an individual suffers from chronic pain, the pain centers of the brain engage in constant pain signaling such that the brain, nervous system, and cells that conduct sensation in the nervous system are on “high-alert” and become more sensitive. This sensitivity maintains chronic pain symptoms. The pain sensations in the brain remain continuously activated, causing the brain to interpret all sensations from the problem area as danger and therefore painful.
Fibromyalgia is a complex syndrome that involves generalized chronic musculoskeletal pain and psycho-somatic symptoms such as fatigue and anxiety. It is diagnosed based on key symptoms of extreme fatigue, pain in multiple tender points, trouble sleeping, anxiety, and memory issues. Stress often makes symptoms worse. The condition can be triggered by trauma, surgery, infection, arthritis, major emotional stress, or develop gradually over time.
Signs and symptoms of fibromyalgia include:
Widespread pain extending on both sides of the body
Tender to touch points that come and go [There are 18 possible tender points, some of which can include the head, neck, chest, shoulders, elbows, hips, and knees.]
Muscle stiffness
Headaches
Fatigue
Memory and cognitive issues
Depression and anxiety
Irritable bowel syndrome (IBS) and irritable bladder
Pain and cramping in abdomen or pelvic area
Difficulty sleeping
Numbness and tingling
TMJ pain
Physical Therapy Treatment for Fibromyalgia
Physical therapists can help patients with fibromyalgia manage pain, reduce fatigue, and improve function and quality of life. Physical therapy is a safe and non-pharmacological method to decrease symptoms of the condition and help patients exercise safely. Physical therapist create an individualized treatment plan, incorporating multiple therapy treatments based upon the patient’s symptoms and condition.
Physical therapy treatment includes:
Regular moderate exercise:
o Aerobic conditioning (walking, bicycling, or elliptical)
o Strengthening exercises
o Stretching and flexibility exercises
Manual therapy
Pain education
Exercise treatment under the supervision of the physical therapist begins with low-impact aerobic exercise in short intervals, gradually increasing the patient’s overall activity level and tolerance for exercise. As the patient grows in strength and aerobic fitness, the exercise program progresses to strengthening muscles and reducing stiffness. Flexibility exercises are used to relieve muscle tension, increase muscle length, and increase motion with the goal of reducing pain and fatigue. Exercise helps patients manage flare-ups of pain and live with chronic pain by increasing overall fitness; exercise also boosts endorphins that help to reduce pain.
An analysis of the prevailing literature on treatments for fibromyalgia found that aerobic exercise is associated with improvements in managing pain and physical function; resistance training resulted in improved function and pain management; and aquatic therapy significantly reduced pain. Aquatic therapy utilizes the buoyancy, density, viscosity, and hydrostatic pressure of water to offer resistance to movement. This helps build muscle with low impact on the joints. The heated water of the aquatic therapy pool helps to reduce pain, inflammation, and stiffness.
Pain education involves understanding how fibromyalgia affects the way the body perceives and responds to pain and ways to manage pain when it does occur. Manual therapy is used to improve range of motion and relieve pain through soft tissue mobilization and manipulation.
Dry needling is also a treatment option for fibromyalgia. Dry needling targets muscles that have trigger points (taut bands of muscle) and helps to relax those muscles that are causing pain and increases blood flow and oxygenation into the sensitive and painful region.
At Mangiarelli Rehabilitation, we understand that managing fibromyalgia can be very challenging. We are here to help you navigate the condition, manage and reduce pain, and help you improve your overall quality of life through safe and effective treatments.
