The rehabilitation of a patient with fibromyalgia is complex. The management of chronic pain, sleep disorders and behavioral/emotional issues, central to fibromyalgia recovery, is challenging. But, a physical therapist can help. At Physicians Physical Therapy Service, the treatment of fibromyalgia includes:
As pain is reduced, a careful progression to gentle exercise is initiated. The exercise is intended to facilitate the safe and efficient performance of daily activities. The progression of exercise is unique to each patient and is guided by both pain and fatigue. Patient’s with fibromyalgia are typically deconditioned; the result of the chronic physical pain and the typical accompanying emotional distress. It is impractical to pursue functional recovery without first addressing general conditioning and specific areas of weakness and limited flexibility.
Cardiovascular exercise is critical. The type of cardiovascular exercise is relatively unimportant. However, the chosen mode of exercise must not exacerbate the pain. Exercise to address specific areas of weakness and those areas lacking necessary flexibility is added as tolerated.
Various Manual Therapies are employed to facilitate muscular relaxation, to increase soft-tissue flexibility, to improve circulation, and to reduce pain. Manual therapies include myofascial release, trigger point therapy, and massage, all well tolerated approaches that focus on specific soft-tissue limitations. Trigger point work is commonly taught as part of the patient’s home program as well.
Instruction in activity modification and sound body mechanics, together with positional sleep strategies and other self-care procedures, allows the patient to begin to assert independent control of the symptoms and resultant disability. The resumption of functional activity, which can be simulated in the clinic, has a profound emotional impact upon those previously limited from performing basic activities of daily living.
The Goals of Physical Therapy
- Decrease pain both at rest and with activity through manual therapy, exercise, and instruction in sound sleeping and working postures and positions.
- Instruct patient in an independent home exercise program emphasizing cardiovascular conditioning.
- Improve the patient’s capacity for functional activities through cardiovascular conditions, strength and flexibility training, activity modification and instruction in safe body mechanics.
Assist the patient by focusing on functional abilities and progress, versus disability and chronic problems.