More and more we are seeing patients come into physical therapy suffering from fibromyalgia as a secondary diagnosis to a primary debilitating illness such as interstitial cystitis. Unfortunately, fibromyalgia is a chronic condition that is often difficult to diagnose but currently affects almost 5 million Americans. Between 80% and 90% of people with fibromyalgia are women. Characterized by widespread chronic pain and fatigue, fibromyalgia is difficult for patients to deal with on a daily basis even more so for those patients who suffer fibromyalgia secondary to another diagnosis.
Luckily, there is evidence that shows physical therapy is beneficial in improving the long-term outcomes for patients who suffer from fibromyalgia. Physical therapy for fibromyalgia offers many therapeutic benefits, including:
- Reducing overload of the muscle system
- Improvement in postural stamina
- Conditioning of weak muscles
- Relief for both generalized pain and trigger points
- Increased ability to perform daily tasks or modify as needed
Research has shown that a multi-disciplinary approach is the most effective in both reducing pain and improving function long-term for fibromyalgia patients. While an individual examination is needed to determine the best course of treatment, there are several modalities which can be utilized in physical therapy to help address the diverse needs of a fibromyalgia patient. The best treatment plan is one that is well-balanced in terms of pain relief combined with exercises geared towards increasing functional ability in daily tasks and job responsibilities.
What is Fibromyalgia?
While it is unknown at this time what causes fibromyalgia, the general thought is it is a chronic condition that causes a dysfunction in how the nervous system processes pain signals. At this time, fibromyalgia has shown to be triggered by diverse events such as traumatic injury, surgery, infection, or emotional distress. And as we mentioned previously, fibromyalgia can also be a secondary condition for people who suffer from other illnesses or diseases like rheumatoid arthritis, systemic lupus, interstitial cystitis, etc.
Signs and Symptoms of Fibromyalgia
Fibromyalgia is a complex condition that has many different signs and symptoms. Patients with fibromyalgia may suffer from one, some of or all of the following:
- Widespread pain often experienced as a dull achiness that can occur on both sides of the body either above or below the waist
- Trigger points that are characterized as tender spots can be found on the head, neck, chest, shoulders, arms, hips, or knees. The pain in these spots can vary with sensations that can come and go
- Full-body muscle stiffness
- Chronic Headaches
- Memory fatigue and difficulty concentrating
- Anxiety or panic
- Pain or cramping experienced in the abdomen or pelvis
- Irritable bowel syndrome or bladder syndrome
- Temporomandibular (TMJ) pain
- Numbness or tingling throughout the body
Fibromyalgia patients experience flare-ups where their present symptoms will worsen. For example, stress has been shown to make fibromyalgia pain worse. Unfortunately, how long a present flare-up will last can greatly vary.
Typically, the patients are prescribed oral pain medication as a way of managing their fibromyalgia pain. However, as the current opioid crisis in our country indicates alternative pain-relieving therapies available through physical therapy are essential for helping fibromyalgia patients manage their condition long-term.
Treatment Plan for Fibromyalgia Patients
While an initial evaluation is needed to create a comprehensive treatment plan to address each patient’s unique symptoms and needs, all rehabilitation regimens will include a combination of both passive techniques along with active treatments and modalities.
Modalities for Immediate Pain Relief for Fibromyalgia
Biofeedback: An abstract published in Evidence-Based Complementary and Alternative Medicinefound that the use of biofeedback significantly reduced pain intensity in comparison to control groups. Biofeedback is useful to help Fibromyalgia patients gain more control over normally involuntary functions with the goal of reducing pain flare-ups and stress response to triggers.
Massage: Soft tissue manipulation can help to decrease muscle tension and muscle spasms while gentle joint mobilizations can help increase range of motion.
Heat Therapy: Heat offers fibromyalgia patients with a non-invasive treatment that deeply relaxes the muscles and increases blood flow to the painful areas. Heat therapy can be used with moist-heat hot packs that come in varied sizes to provide practitioners with targeted treatment.
Hydrotherapy: Warm water whirlpool hydrotherapy is a great treatment to use to reduce pain and muscle stiffness in Fibromyalgia patients. From hi-boy whirlpools to table-top whirlpools, it’s possible to address pain in different areas of the body.
Ultrasound Therapy: Using sound waves, ultrasound therapy produces a gentle heat that enhances blood flow to deep tissues, decreasing pain, inflammation, stiffness, and muscle spasms. Some ultrasound therapy devices, like the Mettler Sonicator 740X, offers different sized soundhead applicators which can be used to offer targeted treatment for trigger points as well as relief for larger areas of the body. Practitioners can also choose from pulsed or continuous modes depending on whether pain is superficial or experienced in the deep-tissue.
Physical Conditioning Modalities for Fibromyalgia Patients
Low-impact aerobic exercise is gentle yet highly effective for conditioning patients with Fibromyalgia. In addition, strengthening and flexibility exercises are useful to help build muscle strength and improve a patient’s range of motion. There are several great modalities that can help accomplish these goals:
Underwater Treadmill: An underwater treadmill is a great choice to use to improve cardiovascular strength and stamina for fibromyalgia patients without unnecessary stress on the joints, making it less likely to trigger a pain flare-up.
Underwater Cycle: Similar to an underwater treadmill, an underwater cycle is a great choice for patients with chronic pain because it is gentle enough for people who suffer joint pain and can gently improve cardiovascular conditioning and lower body strength. The water adds resistance which aids in increasing range of motion.
Functional Exercise using Therapy Bands: Therapy bands allows practitioners to increase overall strength for their fibromylgia patients as part of therapeutic conditioning without undue stress on the joints. With different resistance strengths available, it’s possible to offer full-body graduated strength training making necessary adjustments for gains.
Long-Term Pain Relief Modalities for Fibromyalgia Patients
Transcutaneous electrical nerve stimulation (TENS):A TENS treatment decreases fibromyalgia-related pain by blocking pain signals from reaching your spinal cord. It also reduces muscle spasms and triggers the release of endorphins (natural pain killers your brain produces). TENS units can be used in-office or patients can use a portable unit at home.
While further study is needed to understand the exact cause and triggers for Fibromyalgia, current innovations in physical therapy modalities can offer these patients long-term relief for pain and maintain their function in their daily activities and work responsibilities.
Contact Us Today
We can help you find the right therapeutic devices or equipment to provide relief for your fibromyalgia patient’s unique symptoms. Contact us today and friendly customer service will help you find exactly what you need to help your patients with fibromyalgia achieve long-term relief. Call us today at 1-801-770-3328.