How Physical Therapy Can Relieve Fibromyalgia Symptoms
Fibromyalgia is a chronic pain condition characterized by pain and tenderness throughout the body and extreme fatigue. It is considered a condition that causes central nervous system hypersensitivity and affects nearly five million Americans, the majority of whom are women. Physical therapy is a safe, non-pharmacological method to manage symptoms, reduce pain, improve function and quality of life, and help desensitize the chronic pain response of the nervous system using progressive therapeutic exercise, aquatic therapy, and manual therapy.
What is Fibromyalgia?
Fibromyalgia is a chronic pain condition characterized by significant pain and tenderness throughout the body and extreme fatigue. While the exact cause of fibromyalgia is unknown, experts conclude that the condition is related to hypersensitivity of the central nervous system. This means that individuals with fibromyalgia experience altered sensory processing in the brain, increased activity of pain facilitating pathways, and hypersensitivity and responsiveness to low-impact stimuli that cause excruciating pain. Some doctors conclude that with fibromyalgia, there is often a dysregulation of the stress response system, the HPA axis, and the sympathetic nervous system.
Fibromyalgia affects nearly five million Americans with women experiencing the condition at a 3:1 ratio to men. The condition can be triggered by physical trauma or extreme emotional stress, surgery, infection, or arthritis, or develop gradually over time. Symptoms can flare up without warning or due to stress, changes in weather, or other triggers. Common symptoms of fibromyalgia include widespread pain throughout both sides of the body and tender points that come and go (there are 18 possible tender points extending throughout the head, neck, chest, shoulders, elbows, hips, and knees).
Those with fibromyalgia may also experience fatigue, memory and cognitive issues, headaches, depression and anxiety, muscle stiffness, irritable bowel and bladder, difficulty sleeping, TMJ pain, numbness and tingling, and pain or cramping in the abdomen or pelvic area. Many with fibromyalgia have muscle fatigue and cramping that causes trigger points to develop, small areas of muscle that form a tight knot and fail to relax, causing ongoing muscle contraction that pinches nerves and causes pain.
How Physical Therapy Can Relieve Fibromyalgia Symptoms
Physical therapy can help patients with fibromyalgia reduce pain and fatigue and improve their function and quality of life. Physical therapy is a safe, non-pharmacological method to manage symptoms, improve overall fitness, and help desensitize the chronic pain response of the nervous system.
Physical therapy treatment for fibromyalgia involves both passive and active treatments. Passive treatments can include heat therapy to reduce pain as heat triggers the body’s natural healing process by relaxing muscles and speeding up blood flow to the affected area, which delivers more oxygen and nutrients to the area. Therapists may also use manual therapy and myofascial release to relieve deep muscle tension and spasms and restore range of motion.
Other passive treatments used could be electrical muscle stimulation to reduce muscle spasms and ultrasound, which uses sound waves to create gentle heat that increases blood circulation in deep tissues and reduce stiffness and pain. Physical therapists also provide pain neuroscience education to the patient, explaining the mechanism of pain and chronic pain in the body.
Active physical therapy treatment can include:
Therapeutic exercise for the fibromyalgia patient begins with low-impact aerobic exercise in short intervals to gradually increase the patient’s overall activity level and tolerance for exercise. As the patient improves in strength and fitness, they can begin strengthening and flexibility exercises. Exercise helps patients manage flare-ups and increase overall fitness.
Muscle strengthening and flexibility help lengthen and strengthen muscles which improve joint movement.
Core stability strengthens the trunk and back to better support the spine; the core serves as the center of power and stability for the rest of the body.
Dry needling involves inserting thin needles into trigger points to relax the muscle, ease pain, release nerves, and restore the flow of oxygen-rich blood.
Numerous studies have shown that aerobic and muscle-strengthening exercises are the most effective way to reduce pain and improve function and quality of life in fibromyalgia patients. Patients with fibromyalgia report improvements in pain, energy, mood, and work capacity after an intervention of aerobic exercise.
A review of research studies assessing exercise interventions for fibromyalgia noted that combined exercise programs consisting of aerobic exercise, muscle strengthening, and stretching exercises performed for 45–60 minutes, 2 or 3 times per week for 3–6 months seem to be the most effective in reducing the symptoms of depression and decreasing the pain and severity of fibromyalgia.
Aquatic Therapy for Fibromyalgia
Aquatic therapy in a warm water therapeutic pool can be beneficial for those with fibromyalgia to decrease pain and improve strength and stamina without placing undue stress on joints. The properties of water help to enhance movement and provide resistance when exercising in the water.
The buoyancy of the water supports the joints and body overall, eliminating the impact of movement on an individual’s joints and decreasing weight-bearing stress on joints. The hydrostatic pressure works as a compressive force on the body which helps decrease swelling, increases circulation, and reduces pain. The warm thermal effect of the water also increases blood flow, promotes relaxation, and decreases stiffness.
During aquatic therapy with a physical therapist, the patient is guided through gentle exercises and resistance strengthening (using paddles or water dumbbells) in the water to build muscle strength, increase range of motion, and improve stamina and function.
Fibromyalgia can be a challenging condition to navigate. At Mangiarelli Rehabilitation, we are here to help you manage and reduce pain and improve your overall quality of life as much as possible. Give our physical therapists a call to learn more and take the first step toward improved function!
