Physiotherapy

Fibromyalgia

What is Fibromyalgia

Irregular and widespread pain, together with extreme tiredness and difficulty falling or staying asleep, characterize the chronic condition known as Fibromyalgia. People with this illness experience greater pain than the general population, for reasons that science has yet to fully explain.

The Canadian Rheumatology Association recognizes fibromyalgia as a valid syndrome affecting up to 3% of Canadians. Canadian prevalence rates are in the order of 2% – 3%, with females affected between 6 to 9 times more commonly than males. The majority of people are diagnosed with fibromyalgia while they are in their middle years, however youngsters can also be affected.

Signs & Symptoms

Fibromyalgia is known for causing long-lasting pain all over the body. For fibromyalgia to be diagnosed, the pain must be on both sides of the body, last for more than 3 months, and should be above and below the waist. Pain can spread to every part of your body. Fibromyalgia can also get worse and better over time. This implies that pain conditions do not follow a 24-hour or circadian rhythm.

Pain is the primary complaint in people with Fibromyalgia. Pain onset is usually insidious, sometimes beginning in a localized area, may initially be intermittent, and then progressively becomes more persistent. Although pain is felt in muscle or joint areas, there is no physical abnormality in these tissues.

The National Fibromyalgia and Chronic Pain Association reports that the following factors could affect the pain levels

  • Cold/humid weather
  • Non-restorative sleep
  • Physical and mental fatigue
  • Excessive physical activity
  • Physical inactivity
  • Anxiety
  • Stress

Fatigue, reported by over 90% of patients, is the most common associated complaint. Fatigue may even be more disabling than pain for some and contributes to functional impairment. It is challenging to measure, with reliance on subjective patient reports, to gauge severity.

Nonrestorative sleep is associated with Fibromyalgia. Abnormal components of sleep that have been measured include sleep latency, sleep disturbance, and fragmented sleep leading to impaired daytime function. Poor sleep negatively impacts fatigue, affect, and pain, with improvement in these parameters when sleep specifically is addressed.

Mood disorders, including depression and/or anxiety, are present in up to three quarters of people with fibromyalgia. Anxiety commonly coexists with depression but is also independently present in Fibromyalgia patients. Sexual dysfunction has recently been reported to occur in 97% of Fibromyalgia patients.

Causes of Fibromyalgia

Fibromyalgia changes the way the central nervous system handles pain messages. Through a network of specialized cells, the brain, spinal cord, and nerves of the central nervous system send information to every part of the body. Any unwanted Changes in this system may cause people fibromyalgia.

Our body processes pain because of hormones such as serotonin, norepinephrine (also known as noradrenaline), and dopamine. Hormonal imbalance may interfere with pain signals and increase pain sensitivity.

There is some evidence that fibromyalgia may run in families. It is possible that there is a genetic aberration that has not been detected that puts certain people at a higher risk for developing the disorder. It’s possible that certain genes are responsible for regulating how the body reacts to pain. Researchers hypothesize that persons who suffer from fibromyalgia have one or more genes that enable them to have an exaggerated response to stimuli that another person might not consider to be painful.

Fibromyalgia could have been caused by or made worse by a past illness. Some infections, like the flu and pneumonia, may be linked to gastrointestinal infections caused by the Epstein-Barr virus, such as those caused by Salmonella and Shigella.

In many cases, the onset of symptoms follows a traumatic experience, whether it be emotional or physical, or a struggle with an infectious disease. It is highly unlikely that any one of these causes is responsible for fibromyalgia on its own. However, because they change the way the neurological system reacts to pain, they have the potential to bring on the condition in individuals who were previously at risk for it.

How Is Fibromyalgia Diagnosed

Currently, there is no one-and-done test that can confirm the presence of Fibromyalgia. Diagnosis of fibromyalgia is often done after a thorough physical examination has been performed and all other probable causes have been eliminated. The diagnosis does not require any specialized laboratory or radiologic testing, while some recommended lab tests can be conducted to rule out other illnesses. Examples of exclusionary tests are complete blood count (CBC), erythrocyte sedimentation rate (ESR), basic chemistry (blood urea nitrogen, creatine, hepatic enzymes, serum calcium), thyroid levels (TSH, T3, and T4), and Rheumatoid factor.

The American Rheumatology Association gave their stamp of approval to a revised set of diagnostic criteria for fibromyalgia in the year 2010. They presented these standards in an article that was published in the journal Arthritis Care and Research.

A person is considered to have fibromyalgia if they satisfy all three of the following criteria, as stated in those criteria.

  • A score of seven or higher on the widespread pain index (WPI) and a score of five or higher on the symptom severity scale (SS) are both present in your case. Alternatively, a person has a WPI score between three and six with an SS score of nine or higher.
  • Have been experiencing symptoms for at least three months consistently at the same level.
  • It has been determined that a person do not suffer from any other condition that could account for symptoms present.

Fibromyalgia Treatment

Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and tender points. While there is no cure for fibromyalgia, physiotherapy can play a crucial role in managing its symptoms and improving the quality of life for those affected. 

    1. Gentle Aerobic Exercises: Incorporating low-impact activities such as swimming, walking, or cycling into your routine can help improve cardiovascular fitness and reduce pain. Include keywords like “fibromyalgia aerobic exercises” and “low-impact workouts for fibromyalgia.”

    2. Stretching and Range of Motion Exercises: Gentle stretching exercises can alleviate muscle stiffness and improve flexibility. Highlight “fibromyalgia stretching routines” and “range of motion exercises.”

    3. Hydrotherapy: Aquatic therapy in warm water pools can provide relief by reducing the pressure on joints and muscles. Use phrases like “fibromyalgia hydrotherapy benefits” and “aquatic therapy for fibromyalgia.”

    4. Manual Therapy: Physiotherapists can employ hands-on techniques like massage and myofascial release to relieve pain and muscle tension. Mention “fibromyalgia manual therapy” and “myofascial release for fibromyalgia.”

    5. Strength Training: Strengthening exercises targeting specific muscle groups can enhance stability and reduce pain. Include keywords like “fibromyalgia strength training” and “muscle strengthening for fibromyalgia.”

    6. Mind-Body Techniques: Techniques such as yoga, tai chi, and mindfulness meditation can help manage pain and reduce stress. Emphasize “fibromyalgia mind-body exercises” and “yoga for fibromyalgia relief.”

    7. Education and Lifestyle Management: Educating patients about fibromyalgia and teaching them pain management strategies can be invaluable. Use phrases like “fibromyalgia lifestyle management” and “pain education for fibromyalgia.”

    8. Heat and Cold Therapy: Heat packs and cold compresses can provide immediate relief for localized pain. Mention “fibromyalgia heat therapy” and “cold therapy for fibromyalgia.”

How Physiotherapy Can Help Patient Suffering From Fibromyalgia

Physiotherapy helps restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities. Working one-on-one with people, physical therapists help restore overall fitness and health. The physiotherapist can use various modalities i.e., heat therapy-heat pads, ice packs, to increase blood flow and relax muscles.

They can help alleviate the painful symptoms of Fibromyalgia by relieving stiffness as well as weariness. In addition to engaging patients in physical activity, physiotherapists may use various modalities like electric stimulation to relieve pain.

Supervised stretching exercise and strength/resistance training is highly recommended for the management of chronic pain. It helps increase flexibility and the range of motion.

Regular exercise needs to become part of the usual lifestyle. Progressive incremental improvements in exercise capacity and stretching are recommended. The use of an exercise log that is inspected every few months by the physiotherapist might provide a positive reinforcement. 

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