Fibromyalgia: Introduction
Fibromyalgia is a chronic syndrome, characterized by body aches and pain, weakness, stiffness, tender points around joints and stressful mind.
According to Arthritis India, 0.5-2% of the population is affected by Fibromyalgia & females are 3-7 times more frequently affected. 10-16% of the times, it is associated with the rheumatologic conditions.
The important consideration is that the diagnosis of this condition often gets delayed, before a definitive diagnosis is made.
We at ReLiva Physiotherapy & Rehab help you deal with the various symptoms of fibromyalgia present at any point of this chronic condition in the best possible ways at our clinics in Pune, Mumbai, Thane, Vashi, Nerul and Navi Mumbai.
While there is no definite cure of this condition, physiotherapy helps in :
- reducing the symptoms as well as
- improving the quality of life of an individual suffering from fibromyalgia.
Something as easy as postural correction and correct postural habits taught by the physiotherapist helps the patient in relieving the stress placed on the tissues as well as relaxes the body.
What are the symptoms of Fibromyalgia?
Patients with Fibromyalgia may experience the following:
- Pain areas : muscles and joints
- Pain types : sharp, severe, throbbing, aching, extreme feeling of fatigue
- Sleep : often have sleepless nights, or disturbed sleep. Some may even experience oo much sleepiness
- Gastrointestinal issues: constipation, nausea, loss of appetite
- Systemic: feeling of extreme fatigability and low grade fever
- Muscular : muscle spasm, cramp or soreness (feeling of heaviness and tiredness felt after doing exercise)
- Sensory : pins & needles like pricking sensation at the painful areas, occasionally cold sensitivity
- Mood : often susceptible to mood swings or stress & anxiety
- Behavioral changes : lack of concentration, forgetfulness, feeling of loneliness/ depression
- Others : all the above changing constantly
Can physiotherapy help in Fibromyalgia?
Physiotherapy can play a very important role in managing the signs & symptoms of fibromyalgia.
1. PAIN : Pain, which is the most disabling symptom of this condition, is dealt aptly by :
- Hydrotherapy in the form of moist hot packs that is applied at the painful area or
- Cryotherapy, as per the patients’ condition and need.
- Myofascial release techniques may also be used to release the tension off the muscles as well as produce relaxation.
- Tender point release therapy is used to treat the tender points, which is followed by cryotherapy to reduce pain, promote healing and prevent any muscle soreness.
- Pain may also be treated with the help of electrotherapy equipment like Transcutaneous Electrical Nerve Stimulation (TENS) depending on the severity of the pain.
2 . STIFFNESS: Stiffness is reduced by incorporating various techniques including the following:
- Stretching exercises that help improving the flexibility of the muscles. By loosening up the tight and stiff muscles, it helps reduce the tension built up in the muscles and helps relieve any stress placed on them. This also leads to pain reductionand induces relaxation. Various active and passive stretching exercises are done and also taught to the patient with the correct dosage and method.
- Exercises for accurate range of motion (ROM) are also taught to the patient that helps in keeping the joints healthy and preventing any stiff joint conditions in the future.
- Strength training of the muscles forms the basic line of treatment for the weakness that the muscles develop in fibromyalgia. Gradual and slow progressing strengthening exercises are taught to the patients, starting with free exercises and moving on to resistance training.
- Aerobic exercises (low-speed, low-impact) also form a very important line of treatment in patients suffering from fibromyalgia. Aerobic training helps:
- Prevent the deconditioning of the body
- Induce relaxation
- Significant benefits for physical function, well-being
- Potentially reduce pain
Stationary bicycle, steppers (to perform graded and controlled stair-case climbing) and other devices are used to perform aerobic training. Aerobic exercises help improving the overall quality of life by training the lungs and heart and increasing their ability to function.
3. SLEEP DEPRIVATION: Sufficient sleep can help combat the fatigue symptom in fibromyalgia. A physiotherapist can helpin following ways:
- Relaxation techniques taught to the patients help relax their mind and body and hence bring the stress levels down. This in turn induces good sleep and helps fight sleep disturbances. In this way it helps the patient maintain good health by taking necessary rest periods along with supervised physical activity.
- Lifestyle modification may be suggested to incorporate activities like walking, cycling, swimming, gardening, etc in leisure time. These not only help in :
- relaxing the mind
- also maintain the body strength to fight fatigue and pain.
- Outdoor sports should be taken up to maintain good body functioning, as well as aid relaxation.
Related Reading: Healthy & Positive Habits to Protect you from Stress
What is Fibromyalgia?
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by :
- fatigue,
- sleep,
- memory problems and
- mood issues.
It is a chronic condition diagnosed by the doctors based on patient’s symptoms and physical examination. Fibromyalgia mainly includes widespread muscle pain along with painful point around the joints, which is not actually joint pain but pain in the tissues around the joint. It is usually referred to as ‘fibromyalgia syndrome’ as it presents with a group of symptoms together.
How is Fibromyalgia diagnosed?
There is no single test that can fully diagnose fibromyalgia. In fact people with Fibromyalgia may have a lot of blood tests result that appear normal.
Diagnosis is mainly made on comprehensive physical examination and on the patient’s medical history. Research still continues on devising any specific blood test that could help confirm the diagnosis (e.g. FM/a) to rule out any other serious condition, your doctor may ask you to carry out a compete blood count(CBC), tests for thyroid, etc. Also, since the pain and symptoms are similar to that seen in arthritic conditions like Osteoarthritis and Rheumatoid Arthritis, specific tests to rule out these conditions are also done.
Interestingly the American College of Rheumatology, known as ACR 1990 diagnoses fibromyalgia into the following:
- History of chronic pain with more than a 3 months history – affecting all 4 quadrants of the body (right, left, above & below the waist).
- Tender points – there are 18 designated possible tender points. Pain should be elicited in atleast 11/18 established tender points.
What causes Fibromyalgia?
It is still unclear why people develop fibromyalgia but theories suggest that it is not the outcome of a single factor but combination of factors working together.
- One of the researches suggests that poor physical conditioning leads to the symptoms of fibromyalgia.
- Others suggest that continuous microtrauma leads to ongoing cycle of pain and fatigue.
- Combination of many physical and emotional stressors is believed to be responsible for the condition.
- Genetics is also believed to be one of the causes and fibromyalgia is seen running in families.
- Environmental factors like trauma, infections, etc are also believed to be contributing to causing fibromyalgia.
- Hormonal and chemical disturbances are also responsible for causing pain.
It is mainly thought to be a glitch in the way the body perceives pain. One of the main theories suggests that people suffering from fibromyalgia have developed changes in the way the Central Nervous System (CNS) processes the pain messages carried out by the body. Also low level of hormones like serotonin, noradrenaline and dopamine in the brain lead to alteration in mood, appetite, sleep, behave and response to stressful situations. Also hormones help regulate the processing of pain messages in the brain.
What are the risk factors of Fibromyalgia?
- Family history
- Autoimmune diseases like rheumatoid arthritis, ankylosing spondylitis
- Emotional stress/ trauma
- Certain infections – hepatitis & other medical conditions
Benefits of Physiotherapy Treatment for Fibromyalgia patients
The benefit of physiotherapy is that it allows a person with fibromyalgia to work closely with a trained professional who can design a fibromyalgia-specific treatment program. The therapist documents your progress and gauges whether you are performing/practicing good therapy habits, alignments, and movement patterns when doing ‘homework’ or exercises at home.
Anne Reicherter, PT, DPT, PhD, a licensed physical therapist and associate professor in the department of physical therapy in the School of Medicine of the University of Maryland in Baltimore, says physical therapy can help fibromyalgia patients “manage” their daily living with less pain and generally make life more enjoyable”. She explains that people with fibromyalgia pain are often caught in a vicious cycle: Pain and fatigue prevent them from being active and exercising, but inactivity can trigger more pain and fatigue.
ReLiva Physiotherapy and Rehab helps you deal with fibromyalgia by using the following in their tailor-made and effectively designed treatment program:
- Stretching Exercises
- Strengthening Exercises
- Pain Relief Methods
- Aerobic Training
- Myofascial Release
- Relaxation Techniques
Myths and Facts about Fibromyalgia
Myth 1: Fibromyalgia is rare.
Fact : Fibromyalgia is one of the most common types of chronic pain disorders. Census reports more than 10 million cases per year in India.
Myth 2: Fibromyalgia is “all in the head.”
Fact : Fibromyalgia has been described for centuries. But it wasn’t until 1981 that the first scientific study formally confirmed fibromyalgia symptoms and tender points in the body. Since then, researchers have future tested pain reaction in people with fibromyalgia.
- Imaging studies show that the brains of people with fibromyalgia have more activity in reaction to pain.
- Studies also have shown that people with fibromyalgia feel pain more intensely at lower levels than people without the condition.
Myth 3: Fibromyalgia is women’s disease.
Fact : No…Fibromyalgia can affect men too. Though women are more likely to get Fibromyalgia; based on the studies & statistics
Myth 4: Fibromyalgia pain is mild.
Fact : Pain is a constant for Fibromyalgia. The extent of pain can swing from mild to severe depending on the intensity of the condition & acuteness of exacerbation.
Myth 5: Nothing can be done to treat Fibromyalgia.
Fact : If you have reached this part of this article, you surely know that symptoms of Fibromyalgia can be managed systematically. Call us at 9920991584 and we will connect you to a physiotherapist near you: who will help you break the Fatigue – Pain cycle and support you to beat the symptoms of Fibromyalgia.
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Hope this article helps you in your pursuit of happiness while dealing with Fibromyalgia.
Related Reading:
Back Pain – Causes, Self Care, FAQ and Home Exercise
No time for exercise? 10 tips to get moving
Stretching Exercises : How to Make the Most of it
This article is based on the inputs from Dr Anuradha Mandalekar (PT). Dr Anuradha is a senior physiotherapist at ReLiva and leads the team of clinicians aiding them towards sustainable recovery across a variety of orthopedic, cardio-pulmonary and women’s health issues.
