Physical Therapy for Fibromyalgia: Symptom Management and Quality of Life Improvement

Fibromyalgia is a chronic pain disorder that currently impacts approximately 10 million individuals in the United States alone. It predominantly impacts women that are between the ages of 30 to 50; however, it could impact any one – be it male or female – at any age. This disorder is characterized musculoskeletal pain that is widespread throughout the body. In addition to this, sufferers experience excessive fatigue, problems with sleep, cognitive difficulties (this is also referred to as fibro fog), and numerous other issues.

The symptoms of fibromyalgia impact the sufferer’s ability to function each day, relationships, work, and their general level of well-being. To date, there is no cure available for fibromyalgia; however, there are treatments – such as physical therapy – that helps in reducing the discomfort from the symptoms. It is unknown what causes the disorder, but many medical professionals feel as if it has something to do with the sensitization of the central nervous system. Additionally, trauma, inflammation, and stress levels may play a role in the development of fibromyalgia and the symptoms associated with it.

Even though fibromyalgia patients experience many challenges, physical therapy is a form of therapy that is considered to be one of the best non-medicinal treatments for managing the disorder. This is backed by years of evidence. Physical therapy provides empowerment to patients through the means of education, a customized movement plan, manual on-hands treatments, and self-management.

PT is effective at alleviating pain, reducing stiffness, combatting fatigue, and improves general functioning, the ability to sleep well, improve the mood, and the overall quality of life for those that suffer from fibromyalgia. It helps in the patient developing long-term resilience through the means of retraining the body and the mind in coping with and handling pain signals.

In this guide, we will expound on how physical therapy aids patients that have been diagnosed with fibromyalgia. The information will be drawn from clinical guidelines and evidence, as well as practical approaches. It does not matter if you have recently been diagnosed or you have suffered from fibromyalgia for several years, by gaining a complete understanding of how physical therapy can help you will prove to be a highly transformative experience.

The Symptoms and Day-to-Day Challenges

While fibromyalgia is often described as “widespread pain”, it is actually much more than that. It is a syndrome that is highly complex and it involves pain processing in the central nervous system that is highly amplified. This leads to a heightened level of sensitivity. Medical terms used to describe that which was just provided include “allodynia” and “hyperalgesia”. These are described below:

1. Allodynia – This describes pain that is experienced from a normal touch or touching. An example includes someone tapping someone on the arm.
2. Hyperalgesia – This describes intense pain that is experienced from just a mild prick. An example of this is a tiny pinprick that feels as if a deep stab wound has occurred.

The symptoms that are experienced include – but are not limited to – the following:

• Dull or aching pain on both sides of the body – both above and below the waist area
• Tender point pain is experienced throughout the body. These spots include the head, neck, the shoulders, the chest, the elbows, the hips, and the knees. If firm pressure is placed on these spots, pain is experienced
• Morning stiffness pain and tightness in the muscles
• Chronic fatigue that is not relieved by resting
• Sleep that is unrefreshing, and – in some instances – insomnia, and/or restless legs
• Fibromyalgia often involves the development of headaches, migraines, and tension pain
• Many suffer from mood disturbances – such as depression, and anxiety
• Gastrointestinal issues and bladder issues may affect sufferers
• Many patients experience numbness, tingling, and certain sensitivities – such as noise, light, and/or temperature.

Symptoms with fibromyalgia patients are known to fluctuate and are seemingly made worse by overexertion, stress, weather changes, and /or poor sleep. Once a patient starts to experience a cycle of pain, they will likely reduce their activity levels. In turn, this causes more severe symptoms such as pain, fatigue, and even deconditioning. Physical therapists help fibromyalgia patients break this cycle.

Getting a Diagnosis

Getting a diagnosis of fibromyalgia is often a challenging endeavor because the doctor will need to rule out other conditions – such as Lyme disease, hypothyroidism, and rheumatoid arthritis. There is no one blood test that confirms fibromyalgia. The diagnosis is clinical, though. It is based on the symptoms experienced, tender point sensitivity, and often involves having to have a multidisciplinary team.

Living with Fibromyalgia

Living with fibromyalgia often results in reduced physical activity, withdrawal from social activities, and a work capacity that is completely diminished. Most patients experience what is called “Kinetophobia”, which is the fear of pain. As a result, the sufferer avoids movements. In turn, this increases weakness and stiffness in the muscles of the body. Physical therapy offers a proactive approach to this so that it does not occur. That is one way in which PT is effective.

The Role of Physical Therapy in Management of Fibromyalgia

Those that work in physical therapy are experts in movement. They receive comprehensive training in the areas of assessment of the gait, posture, strength, flexibility, and pain patterns. PT is hailed as a cornerstone of multimodal care for fibromyalgia. A patient will often go through physical therapy in addition to medication therapy, psychological therapy, and modifications to the lifestyle.

The guidelines in physical therapy include pain-based physiology, exercises that place an emphasis on strength, and aerobics. Other modalities that are more passive may be used as a single treatment, but it has been found that combined approaches to care deliver superior results.

The Detailed Ways Physical Therapy Helps

There are numerous detailed ways that PT helps fibromyalgia patients. The following outlines these ways:

1. The physical therapist aids in reducing the perception of pain by encouraging graded exposure to techniques and unique movements that help in desensitizing the nervous system of the body.
2. It provides an improvement in physical-based function through the means of exercises that are progressive that slowly build endurance without overwhelming the senses and/or the nervous system.
3. It helps in decreasing the levels of fatigue that the sufferer experiences by increasing the amount of cardiovascular fitness and sleep quality.
4. The quality of life is improved by helping to improve mobility and the mood.
5. Pain intensity is reduced, tender point sensitivity is improved, and the strength is increased.

What Happens at The Physical Therapy Appointment?

If you have fibromyalgia, you should know and understand what will happen at your first appointment with your physical therapist. The following outlines what typically happens:

1. First, you will undergo an initial evaluation. Here, you will work with the physical therapist to set goals, complete hands-on interventions, and to set up a customized care plan.
2. Next, your therapist will provide information on fibromyalgia and the neuroscience behind the symptoms that you experience. This helps to reduce fear and increase your confidence levels in both the treatment and the therapist that you will be working with.
3. The physical therapist will often explain various resources that are available to you. Examples include books on the condition, physical therapy, and/or information on local support groups
4. You will be instructed on the concept of balancing your activity level with rest. Additional topics may include energy conservation, proper sleep hygiene, and even stress management.
5. You will be educated on flare-ups and learning how to identify the triggers that cause the flare-ups, that way, activities may be modified.
6. Then, you will move into exercise therapy. This is the most researched of all treatments for the condition. You should start off low and go slow. As time progresses, you can then increase the intensity of your exercise regimen. This way, you do not get post-exertion issues.
7. When you engage in physical therapy, you will be doing aerobic conditioning. Activities include brisk walking, swimming, and cycling. Initially, you will likely start on 10 minute sessions and will work towards 150 minutes a week.
8. Next, you will be required to do resistance training. This will help to increase your strength and will improve your overall functionality. You will find – over time – that your pain thresholds improve and you have less pain. During this training, you may use resistance bands, free weights, or special machines.
9. While going through physical therapy, you will do flexibility and stretching exercises. This training will help eliminate morning stiffness, and provide a boost to your range of motion. Examples include yoga and tai.
10. Water therapy may be prescribed during physical therapy. This helps reduce the load on your joints. It also helps in improving circulation in the body.

If you are ready to get relief from the symptoms of fibromyalgia, physical therapy is the way to go. We here at Back to Motion Physical Therapy are standing by and ready to help you get your quality of life back, just give us a call for more information: 303-832-5577