Rebecca Wagner, PT

FM – Turn Down the Volume

Fibromyalgia (FM) is defined as widespread musculoskeletal pain that can include achiness, tenderness, and stiffness. It often is accompanied by fatigue and psychological changes, such as depression. Current theory states this condition is caused by central sensitization; that is, increased sensitivity in the brain to pain signals. This sensitization includes a change in the levels of the neurotransmitters resulting in amplification by pain receptors in the brain. Normal stimuli are perceived as painful. Think of a radio with the volume blasting that needs to be turned down.

So far, the exact cause of fibromyalgia is not known. There are several theories regarding what can trigger the onset: physical trauma, surgery, viral or bacterial infection, significant psychological stress, hypermobility, immune system dysfunction, abnormal brain function during sleep. Symptoms can accumulate gradually over time without a triggering event. Women are more likely than men to develop this condition

Fibromyalgia is diagnosed by ruling out other conditions. A diagnosis of fibromyalgia includes widespread pain longer than three months and pain and tenderness at 11 or more of the 18 identified tender points on the body. In addition to the widespread pain, some of the frequent signs and symptoms include headache, TMJ disorder, irritable bowel syndrome and other GI disturbances, fatigue and sleep disturbances, poor concentration and memory problems.

Treatment for fibromyalgia includes managing it with medication and elements of self-care: exercise, stress management, healthful eating and good quality sleep.

Treatment for fibromyalgia includes managing it with medication and elements of self-care: exercise, stress management, healthful eating and good quality sleep. Medication that is managed by a health care provider can include analgesics, antidepressants, and anti-seizure drugs. Exercise should consist of a gentle program incorporating stretching, strengthening and aerobic activity with a gradual progression. Stress management can include coping skills and strategies: pacing oneself by modifying a schedule and/or breaking down activities, taking breaks, removing stressor(s), exercising and meditation. Utilizing sleep hygiene elements to ensure getting proper rest is an important component for managing the symptoms of fibromyalgia.

Successful management of fibromyalgia involves active participation and a take-charge attitude. Utilizing modalities (ice/heat) for symptom relief, developing coping skills and strategies to reduce stress and getting adequate rest and nutrition are key for successful management. As stated by a former patient, it can simply entail “resting when you’re tired; eating when you’re hungry.”

If you have fibromyalgia, consider consulting a physical therapist. Ask your rheumatologist more about physical therapy at ARTS in order to teach you how to better manage fibromyalgia and similar conditions.


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