If you feel pain after an injury, the reason behind the pain is fairly logical—there is a cause and effect relationship that can be observed clear as day. But in some cases, such as Fibromyalgia Syndrome (FMS), the origin of pain is not obvious at all. The American College of Rheumatology defines FMS as the presence of widespread aching and pain that has been present for at least 3 months, and tenderness with pressure in at least 11 of 18 sites across the body. For many years, FMS has incited considerable debate and controversy. What does the precise definition of the condition really mean for patients, and why would they care if all they know is that they are in pain? Due to FMS’s mysterious onset, it is safe to say there are a good number of people who haven’t been diagnosed or received adequate treatment for the condition.
Much like treatment for many musculoskeletal pain disorders, the optimal treatment for FMS includes an advanced therapeutic exercise program of physical activity. Because FMS can greatly affect physical and mental capacities, appropriate pharmacological management is also needed in many cases. Symptoms may include any of the following:
- Pain and morning stiffness
- Swollen joints
- Temporomandibular dysfunction (TMJ)
- Numbness of the extremities or face
- Restless leg syndrome
- Leg and foot cramps
- Weight gain
- Low grade fever
- Lowered immunity to infections
- Night sweats
- Sensitivity to temperature changes
FMS can also have a severe impact on mental health. It can lead to overwhelming fatigue, irritability, apathy, impaired memory and concentration, insomnia or non-restorative sleep, anxiety, depression, and even suicidal thoughts.
With so many different symptoms, it can be difficult and overwhelming for individuals to figure out a proper plan of care. That being said, there are vast amounts of research available to support the use of strengthening programs and aerobic programs in treatments, along with education about FMS, to help patients manage symptoms and enjoy a greater quality of life. Regular exercise can boost your body’s endorphins, decrease stress, and improve energy levels, flexibility, and strength. Other benefits may include decreased mental stress and a lower risk of anxiety and depression.
Types of exercise that have been proven to treat chronic symptoms include:
- Aerobic exercise, which is non-impactful, low resistance, and high repetition, such as:
- Pool exercises
- Brisk walks
- Bike riding
- Tai Chi
- Flexibility and low resistance strength training in the following muscle groups:
- Upper trapezius
- Levator scapulae
- Gluteus maximus
Patients with FMS have up to 18 tender points, so training usually has to address many different areas of the body. As with any exercise program, make sure your training is tailored to your individual needs before beginning a new regimen.
Physical exercise is not the only important component of managing chronic pain due to FMS. Two major keys to overall care include goal-setting activities and pacing. Goals should be realistic and meaningful. They should be specific, and not an umbrella goal of experiencing zero pain whatsoever. Lifestyle goals such as traveling to visit family or friends could be the initial focus. If you begin by putting too much pressure on yourself to achieve difficult or impossible goals, you might become quickly discouraged. Having a number of smaller but meaningful goals will help you continue along the path to recovery. Pacing is also incredibly important, and patients should remember to set tasks in a graded manner so you can build confidence and tolerance along the way. Remember, too much inactivity can be debilitating and could lead to more pain – however, overdoing it can be just as harmful.
As physical therapists, we are trained to properly evaluate, assess, and implement a proper therapy plan of care that can incorporate all facets of physical activities needed to alleviate symptoms of FMS. With the help of skilled professionals, plans of care can be properly organized and tailored to each individual’s needs, and realistic goals can be set so you can ultimately improve your quality of life. If you have further questions about Fibromyalgia and PT, contact your local Foothills Sports Medicine Physical Therapy clinic today!