Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep disturbances, and memory issues. Physiotherapy for Fibromyalgia can help manage symptoms. It can affect both children and adults, with women being more prone to developing the condition than men.
Pathophysiology of Fibromyalgia
Fibromyalgia is primarily caused by disordered central nociceptive signal processing, which results in sensitization—expressed as hyperalgesia (increased sensitivity to pain) and allodynia (pain from non-painful stimuli).
It shares similarities with other chronic pain conditions such as:
- Irritable Bowel Syndrome (IBS)
- Interstitial Cystitis
- Chronic Pelvic Pain
- Chronic Low Back Pain
Another contributing factor is an imbalance between excitatory and inhibitory neurotransmitters, leading to enhanced pain perception.
Fibromyalgia Rapid Screening Tool (FIRST)
The Fibromyalgia Rapid Screening Tool (FIRST) is used as a quick and efficient method to help in the diagnosis of fibromyalgia.
Clinical Features of Fibromyalgia
People living with fibromyalgia may experience:
- Chronic diffuse pain
- Muscle stiffness and tenderness
- Joint pain or deformities in some cases
- Fatigue
- Sleep disturbances – including difficulty falling asleep, frequent awakenings, and feeling unrefreshed upon waking
- Cognitive problems (commonly known as “fibro fog”)
Role of Physiotherapy in Managing Fibromyalgia
Physiotherapy plays a key role in managing fibromyalgia symptoms through a variety of approaches.
1. Exercise Therapy
Patients with fibromyalgia often show intolerance to physical activity, which can lead to additional comorbidities. However, exercise is essential to reduce pain and fatigue.
- People with fibromyalgia generally have low aerobic endurance and reduced muscle strength, which limits their ability to perform daily tasks.
- Hydrotherapy or aquatic training is beneficial due to the buoyancy of water, which reduces joint stress and helps strengthen muscles.
- Modified Pilates methods that focus on mobility, stretching, and strengthening exercises are also helpful.
2. Manual Therapy
Massage Therapy
- Widely used for managing fibromyalgia
- Improves pain, anxiety, depression, and sleep disturbances
Myofascial Release Technique
- Enhances flexibility and blood circulation
- Reduces stress, fatigue, and fibro fog
- Contributes to pain relief and better quality of life
3. Joint Mobilization
- Aims to reduce joint stiffness and improve restricted range of motion
- Grade 1 & 2 mobilizations – pain relief
- Grade 3 & 4 mobilizations – range improvement
4. Electrotherapy Modalities
- TENS (Transcutaneous Electrical Nerve Stimulation) and Ultrasound (US) are effective for symptom management
- Help in reducing pain and improving function
5. Photobiomodulation Therapy (PBMT)
- Involves application of light to stimulate cellular activity
- Enhances ATP production in mitochondria
- Provides benefits like analgesia and tissue regeneration
Conclusion
Fibromyalgia is a complex condition that demands a multidisciplinary treatment approach. With appropriate physiotherapy interventions such as exercise therapy, manual therapy, mobilization, and electrotherapy, individuals can experience significant symptom relief, improved function, and enhanced quality of life.
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