Have you ever wondered what exactly is Fibromyalgia? Or have you been diagnosed with Fibromyalgia and are looking for clarity? Fibromyalgia is a chronic pain condition which the cause of is unknown but may have genetic and environmental influences. Fibromyalgia can have consequences to health status, quality of life, and social activities.
What researchers know is that people with fibromyalgia have altered chemical and neurological pain processing systems which are sensitized to pain. This can lead to hyperalgesia (heightened pain to a normally painful stimulus) and allodynia (pain to what should be a non painful stimulus). That is not at all to say that the pain ‘ is all in your head’. When the body is no longer able to properly process stimuli, chronic pain may develop as well as a fight, flight, or freeze response. This is hyperactivity of the sympathetic nervous system (which is responsible for the fight/flight/freeze response). Hyperactivity of the sympathetic nervous system may put the autonomic nervous system off kilter (the autonomic nervous system is responsible for maintaining homeostasis or balance in the body by regulating internal organs function and vital signs which can include blood pressure, heart rate, etc.)
In simpler terms, because it is complicated!, the body may be more sensitive to pain, which may make existing or new aches and pains, worse. Or it may make something which shouldn't be painful (or shouldn't be painful for long) into chronic pain. This can trigger fight, flight, or freeze responses which reduce the body's ability to cope with the pain and regain normal function.
Along with pain hypersensitivity, other symptoms may include poor sleep quality, anxiety, and depression (all which have been shown to heighten pain! So it becomes a vicious cycle). Fibromyalgia may be present in up to 6.6% of the general population and is most common in women 20-50 years old.
So, what is the best way to manage fibromyalgia in a physiotherapy setting?
Research says that aerobic (walking, swimming or any activity that raises your heart rate) and resistance exercises (especially water-based) are effective when considering exercise options. Manual therapy such as myofascial release, connective tissue massage, manual lymph drainage and shiatsu are all also very beneficial. As an adjunct treatment, TENS machine and other electro therapy can also benefit those with fibromyalgia.
Fibromyalgia research is still growing and studies are linking potential triggers to trauma (physical and emotional) and infection.
With these findings, it’s especially important to consider the Biopsychosocial Model of Pain. This model believes that pain is multidimensional, and that there are dynamic physiological, psychological, and social factors that are constantly at play influencing chronic pain. This is why chronic pain is often very difficult to treat, and treatment is reliant on understanding and effecting each of these domains of the Biopsychosocial Model. It also explains why emotional triggers can increase pain and vice versa! Finding activities such as yoga and meditation to help manage stress can be very beneficial, as well as attending counselling to help understand traumas and triggers. Pacing (reducing and spacing out workloads) is also very important when dealing with a flare up. And finding professionals such as our physiotherapists at Access Physiotherapy who are well-equipped to help manage Fibromyalgia and other Chronic Pain conditions, is extremely helping for managing Fibromyalgia!
Feel free to comment any questions!
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Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiatry. 2018 Dec 20;87(Pt B):168-182. doi: 10.1016/j.pnpbp.2018.01.017. Epub 2018 Jan 31. PMID: 29408484; PMCID: PMC6067990.