Fibromyalgia is a musculoskeletal condition that causes pain and tenderness throughout the body. Often fibromyalgia affects the joints, muscles, tendons, and other soft tissues. This condition is most common in women between the ages of 20 and 50.
Causes
The exact cause of fibromyalgia is unknown. Possible triggers, or situations that may cause symptoms to flair up include:
- Physical or emotional trauma
- An abnormal pain response in the brain
- Sleep disturbances
- Depression and anxiety
Symptoms
- Pain, ranging from mild to severe, throughout the body
- Tender points in the soft tissue of the neck, shoulders, chest, hips, shins, elbows, or knees.
- Pain that radiates out from the tender points
- Pain that gets worse with activity, stress, or in cold and damp weather
- Sleep disturbances, with pain that gets worse at night
- Numbness and tingling in the hands and feet
- Tension or migraine headaches
Physical Therapy Interventions
Physical Therapists are professionals, educated and trained to administer interventions. As defined by The Guide to Physical Therapist Practice, interventions are the skilled and purposeful use of physical therapy methods and techniques to produce changes consistent with the diagnosis, prognosis and the patient or client’s goals.
A physical therapist will perform a thorough evaluation to assess and determine the following:
- Joint: a series of measurements will be performed to determine which joint is involved and the extent to which the inflammation is acute
- Strength: resisted testing is performed to determine if there is associated weakness or strength imbalances
- Flexibility: range of motion measurements will be taken to determine if there is reduced joint movement
- Technique and ADL: the therapist will review what activities you have difficulty with and will help you make modifications in technique to reduce stress on the involved joint.
- Gait, Balance and Alignment: the therapist will assess your gait and balance on even and uneven surfaces. An assistive device such as a cane or walker may be indicated to improve safety, gait and reduce stress on the effected joint.
Physical therapy for fibromyalgia must remain conservative at the onset to avoid aggravating the condition. Emphasis will be placed on rest, reducing the inflammation, protecting the joint and increasing the blood circulation for healing. Once the initial inflammation has reduced, a program of stretching and strengthening will be initiated to restore flexibility and improve strength and function.
Treatments
- Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, stretching and joint mobilization by a physical therapist to improve alignment, mobility and range of motion of the affected joint. The use of mobilization techniques also helps to modulate pain.
- Therapeutic Exercises (TE) including stretching and strengthening exercises to regain range of motion and strengthen muscles of the joint and affected extremity to support, stabilize and decrease the stresses place on joint cartilage.
- Neuromuscular Reeducation (NMR) to restore stability, retrain the affected extremity and improve movement techniques and mechanics (for example, running, kneeling, squatting and jumping) of the involved extremity to reduce stress on the joint surfaces in daily activities.
- Modalities including the use of ultrasound, electrical stimulation, ice, cold, laser and others to decrease pain and inflammation of the involved muscles and joints.