What is Fibromyalgia?

Fibromyalgia (FM) is a disabling condition that was first recognized and named by doctors of rheumatology, probably because it is characterized by widespread chronic pain and stiffness, numerous chronic tender points (more than 11 of 18) and chronic fatigue with exertion intolerance reminiscent of arthritis and autoimmune disease. Other typical symptoms include disordered or non-refreshing sleep patterns, headaches, mood or cognitive complaints (such as "brain fog"), irritable bowel syndrome, and other types of autonomic nervous system dysfunction. 1 There seems to be a disturbance of the central nervous system, resulting in increased pain sensitivity and abnormal central pain processing. which in turn contributes to more pain, tightness and spasm of the tension bearing muscles, connective tissues and associated areas of the brain. Fibromyalgia typically strikes women three times more often than men, with a median age of 40-50, either definite or gradual in onset, often following periods of emotional stress, and sometimes associated with infection, hormone shifts such as menopause, surgery, or mechanical trauma.   

How Can a Physical Therapist Help?

Managing fibromyalgia can be challenging due to daily variation of painful symptoms, de-conditioning, and the impact of other related symptoms.   Research suggests that exercise is an important part of managing fibromyalgia; yet pain often keeps people from beginning an exercise program. Pain leads to inactivity which then causes further deconditioning.  This debilitating cycle can have severe impact on the quality of life for a fibromyalgia sufferer.  A physical therapist helps a person understand pain signals and manage and decrease symptoms through gradated exercise. 
Physical therapy programs involve both passive and active treatments.   Typically, a therapist will begin with passive treatments to reduce the pain and prepare a person for increasing mobility. When the patient is ready, active treatments begin that will help strengthen the body, increase strength and mobility, and reduce fibromyalgia-related pain. The physical therapist helps the patient determine the pace appropriate to her/his needs and ability.

Passive treatments may include deep tissue massage, heat therapy, hydrotherapy, electric muscle stimulation, and ultrasound.  These treatments are designed to relieve muscle tensions, relax muscles, reduce chronic pain, and help trigger the body’s natural healing processes. 

Active treatments include a variety of exercises to strengthen core (abdominal), back, arm and leg muscles, and increase flexibility. These treatments will not only curb chronic pain but benefit overall health. A physical therapist works with the patient to develop a program based on specific symptoms, tolerances, and health history.  Active treatments include strengthening core muscles, flexibility and motion enhancement, and water-based exercise.  The goals are to provide gradated aerobic and muscle conditioning to improve general mobility and quality of life.  The physical therapist monitors the patient’s response and tolerance to ensure that the person does not fall into the pain-inactivity-deconditioning cycle once again.

Conclusion

Research shows that physical therapy seems to reduce disease consequences. A multidisciplinary approach combining physical therapy with physician care and other options may provide promising results.  With this potentially disabling condition, physical therapists are part of the solution to getting fibromyalgia patients back on their feet and improving their quality of life.

References

About Fibromyalgia
The Organization for Fatigue & Fibromyalgia Education & Research (OFFER)
http://offerutah.org/fibromyalgia.htm

Move Forward - the website of the American Physical Therapy Association
Fibromyalgia
http://www.moveforwardpt.com/find-your-condition/fibromyalgia/

Physical therapy in the treatment of fibromyalgia
Offenbacher, M. Stucki G.
Department of Physical Medicine and Rehabilitation, University of Munich, Germany.
http://www.ncbi.nlm.nih.gov/pubmed/11028838

Spine Universe
Physical Therapy for Fibromyalgia, author Kelly Rehan (3/09) for Spine Universe
http://www.spineuniverse.com/conditions/fibromyalgia/physical-therapy-fibromyalgia