What is Fibromyalgia?
Fibromyalgia is a disorder that causes muscle pain and fatigue (feeling tired). People with fibromyalgia have “tender points” on the body. These tender points tend to occur in specific places on the neck, shoulders, back, hips, arms, and legs. The points can be quite painful when pressure is placed upon them.
Fibromyalgia is difficult to diagnose, but it is estimated to affect about 5% of the population. It tends to occur in women much more than men, and generally starts in middle age.
What Causes Fibromyalgia?
Unfortunately the cause of fibromyalgia is unknown. It has been linked to:
– traumatic/ stressful events such as a car accident
– repetitive injuries
– certain diseases, such as lupus, rheumatoid arthritis, and ankylosing spondylitis.
What are the Symptoms of Fibromyalgia?
Pain, stiffness, tiredness and tenderness of the muscles, tendons, and joints.
Restless sleep, awakening feeling tired, chronic fatigue, anxiety, depression, and disturbances in bowel function.
How is Fibromyalgia Diagnosed?
The symptoms of fibromyalgia can be associated with many conditions or diseases, making it difficult to diagnose. There is no blood test, finding on imaging or other diagnostic procedure that doctors can use to definitively tell a patient that they have fibromyalgia.
Generally then, diagnosis is made by your doctor or physiotherapist ruling out other diagnoses, as well as findings on physical testing of the body. One test that your health practitioner can do is to palpate a number of points around your body.
If a large portion of these points are tender to touch, it may help support a diagnosis of fibromyalgia.
Conditions that can mimic the features of fibromyalgia include an underactive thyroid (hypothyroidism), vitamin D deficiency causing the bone disease osteomalacia, rheumatoid arthritis and even sleep apnoea.
The management of fibromyalgia is complex, but can be broken down into a number of parts. Treatment tries to help you slowly break the fibromyalgia cycle by addressing each of the points shown in the diagram above.
Relief of your muscle and joint stiffness, tenderness and pain
The first part of helping you manage fibromyalgia is to help provide some pain relief. This may involve soft tissue massage, acupuncture or joint mobilisation to improve muscle tightness, tenderness and joint stiffness.
Managing your fatigue and limited activity
The best way to help treat fibromyalgia in the long term is through exercise. It is important, however, that this exercise is slowly progressed to allow your body to cope with increased activity levels. There are three types of exercise that may be given to you:
– stretching and mobility exercises to help improve pain, stiffness and tightness.
– specific strengthening exercises to help build strength and endurance in the ‘posture’ muscles of the body, and take the load off other overactive, achy muscles.
– general exercise, such as going for a gentle walk or bike ride, yoga, tai chi or pilates.
Fibromyalgia symptoms can fluctuate, meaning that you can have both good and bad days. Sometimes overdoing it one day can lead to increased symptoms the next day, so being able to manage your effort important.
Improve your ability to cope with daily stress and depression
Daily stresses from work or home can increase your fibromyalgia symptoms. You and your physiotherapist can work with your GP to help you develop strategies to manage these stresses.
In some cases your GP may prescribe medications such as an antidepressant to help normalise chemical imbalances and also improve pain. Referral to a psychologist can also help in developing strategies to cope with stressful situations.
General exercise, is an excellent way to help deal with stress and depression. Exercise, amongst other things, releases ‘happy’ chemicals such as endorphins that help to provide relief of your symptoms. Regular exercise also helps to improve eating and sleeping habits, which will lead to better general health and less sleep deprivation.
Have a Treatment Goal
Some people find it beneficial to have a goal to strive for. Your physiotherapist will tailor your rehabilitation to help you achieve your own functional goals. During this stage of your rehabilitation is aimed at returning you to your desired activities.
Everyone has different demands for their bodies that will determine what specific treatment goals you need to achieve. For some it be simply to walk around the block. Others may wish to run a marathon or return to a labour-intensive activity.