Fibromyalgia is a chronic pain condition that affects an estimated 10 million people in the United States, and an estimated 3-6% of the worldwide population. Though it is a painful syndrome that affects individuals differently, most affected feel widespread pain and overall fatigue. Additional symptoms could be, but are not limited to, overall weakness, muscle spasm, irritable bowel symptoms and sleep disturbances.
When one who is diagnosed with fibromyalgia sustains an orthopedic or neurologic injury and is referred to physical therapy, the pre-existing condition makes treatment complex. Individuals that are treated by a physical therapist with injuries such as shoulder impingement, degenerative joint disease, ankle sprains or plantar fasciitis, typically have a total body response because of the pre existence of their fibromyalgia.
Despite the preconceived notion of the condition most physical therapists have, fibromyalgia is more than a precaution that must be monitored when rehabbing some of the aforementioned injuries. Physical therapy can successfully treat fibromyalgia as a primary diagnosis.
Physical therapy is rarely one of the initial thoughts for fibromyalgia treatment by both patients and providers, it is a medically based profession specializing in pain relief. PT’s work with individuals to develop a treatment plan to decrease pain by identifying and addressing its causes.
Though it varies from state to state, many don’t require a doctor’s referral or prescription to see a physical therapist. PT’s can and, many will begin your treating your pain on the first visit, so you walk out the door feeling better then when you walked in.
Additionally, since physical therapy is a medically based profession the services are covered by most medical insurance plans with limited out of pocket cost.
Treatment plans take a comprehensive approach by working on pain’s typical triggers: posture, joint alignment, muscle strength, flexibility and nerve involvement. A good program will take both an active, exercise based approach, as well as a passive one. The ultimate goal would be to educate the client so that they can be independent in their program.
Many physical therapists have a limited understanding of this condition limiting their plans of care. Additionally, many physical therapy practices where one may be treated by an aide or where the physical therapist is monitoring three to four patients are not settings conducive to success with fibromyalgia.
Since fibromyalgia affects individuals differently it is imperative that an individual is evaluated differently. One should be evaluated by a skilled physical therapist with experience in treating this condition, be it the primary or secondary reason for the visit. A treatment program must individually focus on the needs and specific symptoms of the client. Those diagnosed with fibromyalgia need to be closely observed to insure that that physical therapy treatment program does not result in a symptom flair exacerbation.
Individuals need to be monitored to verify that the therapeutic exercises are being done correctly at all times because improper muscle substitution or muscle compensation can lead to an increase in symptoms. The body is designed to constantly work more efficiently and therefore compensate. Compensation is something that must be monitored in every patient; it can cause irregular muscle firing patterns that places the body under unneeded stress resulting in pain. The risk of compensation is amplified in those with fibromyalgia;
In an ideal situation the best way to initiate a therapeutic exercise program, especially for someone who is sensitive to fibromyalgia flair ups is through an aquatic physical therapy program. The water unweights the weight bearing joints, offering gentle resistance which can introduce exercise without an overworking the muscles and be the starting point. With that said, the most effective combination would be a aquatic/land program, initially the aquatic would work on building strength and endurance, the land would primarily focus on flexibility, the ultimate goal is to progress to full land therapy to continue to improve endurance.
Though every program is individually outlined there is a strong link between poor posture and fibromyalgia symptoms. Be wary of treatment programs that are only modality based, do not provide a home program or do not address posture, scapular stabilization and core musculature. These types of programs fail the client by not providing a true solution for the pain.
Initiating a conversation with a physical therapist or your doctor about physical therapy treatment could be the first step to finding the missing piece in your comprehensive fibromyalgia pain relief program.
Christopher Stulginsky, PT is a physical therapist at Ayrsley Town Rehabilitation, in Charlotte, NC. He his a Prehab Network Specialist and is an 830 Cold Laser Certified Premier Provider.
Christopher is a 2003 graduate of the physical therapy program at The Rangos School of Health Sciences at Duquesne University in Pittsburgh, PA. After graduation he spent 4 years as a travel physical therapist working throughout the United States. His travel background afforded him the opportunity to learn various techniques and about different technologies that were being used around the country. Additionally, Christopher has worked in multiple settings and multiple institutions including: The Johns Hopkins Hospital in Baltimore, MD; Friday Harbor Physical Therapy in Friday Harbor, WA; Mercy Hospital, West Suburban Sports and Rehabilitation Clinic and Westlake Hospital in Chicago, IL.
For more information, please visit: www.ayrsleyrehab.com
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Ayrsley Town Rehabilitation (ATR) is an independent physical therapy clinic which was opened by Christopher Stulginsky and Alex Gomez in October of 2008 in The Town of Ayrsley, located in southwest Charlotte.