Physical Therapy for Fibromyalgia

Fibromyalgia is an umbrella term for a complex chronic pain syndrome affecting approximately 4 million American adults (CDC, 2022). The cause of fibromyalgia is unknown, however, it is thought to occur due to alterations in how the brain and nervous system process pain. This condition can be effectively managed through a multi-modal approach including physical therapy.

Individuals with fibromyalgia experience a wide range of symptoms including:

• Widespread pain that may move from one area to another
• Muscle stiffness and tension that is often worse in the morning
• Cognitive symptoms including difficulty concentrating and impaired memory
• Depression/anxiety
• Various spots in your body that are tender/painful to the touch
• Sleep disturbances and/or excessive fatigue
• Numbness and tingling 

How can Physical Therapy help with Fibromyalgia?
As with all types of chronic pain, fibromyalgia can result in decreased physical activity levels. Physical therapy can help you manage your symptoms, which in turn can help you increase your activity levels and improve your quality of life. 

Physical therapy treatments include:

• Education on lifestyle strategies helpful for managing your specific symptoms including appropriate goal setting, activity modification, and stress and sleep management.
• Graded exposure to movement to help you gradually improve your tolerance for activity and your quality of life. Graded movement guided by your physical therapist is carefully designed to decrease the “threat” response and therefore decrease the sensation of pain, while simultaneously building your physical capacity.
• Aerobic exercise can improve your heart, lung and muscle function. It includes movements like cycling, brisk walking, swimming or using an elliptical machine. Moderate aerobic exercise is beneficial for managing symptoms and improving physical function.
• Strengthening exercises have been shown to improve muscle strength and function to improve quality of life.
• Manual therapy such as soft tissue mobilizations, dry needling, and joint mobilizations can help manage pain and improve joint and muscle function.

Your physical therapist can develop an individual exercise program for you that allows you to participate in exercise while limiting significant exacerbation of your symptoms. 

References:

1. Brauer, S. (2008). Fibromyalgia: Ottawa Panel Evidence-Based Clinical Practice Guidelines: the exercise management of fibromyalgia. Australian Journal of Physiotherapy, 54(4), 286-287.
2. Brosseau, L., Wells, G. A., Tugwell, P., Egan, M., Wilson, K. G., Dubouloz, C. J., … & Veilleux, L. (2008). Ottawa Panel evidence-based clinical practice guidelines for aerobic fitness exercises in the management of fibromyalgia: part 1. Physical therapy, 88(7), 857-871.
3. Brosseau, L., Wells, G. A., Tugwell, P., Egan, M., Wilson, K. G., Dubouloz, C. J., … & Veilleux, L. (2008). Ottawa Panel evidence-based clinical practice guidelines for strengthening exercises in the management of fibromyalgia: Part 2. Physical therapy, 88(7), 873-886.
4. Wolfe, F., Ross, K., Anderson, J., Russell, I. J., & Hebert, L. (1995). The prevalence and characteristics of fibromyalgia in the general population. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 38(1), 19-28.
5. Dailey, D. (2016, April 16). Physical Therapy Guide to Fibromyalgia. Choose PT. Retrieved February 20, 2023, from https://www.choosept.com/guide/physical-therapy-guide-fibromyalgia

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