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Fibromyalgia – What to Do When the Fibro Ignites

Used with permission from the APTA Private Practice Section

As we head into the dog days of summer, the weather is heating up. For the nearly 5 million people in the United States with Fibromyalgia, they might experience a different kind of heat – the burning pain that typically comes along with this diagnosis.

What is Fibromyalgia?

Fibromyalgia is a chronic condition that can cause a wide range of symptoms throughout the body. It’s usually diagnosed between the ages of 30 and 50, and 80% to 90% of the people affected are women.

The most common symptoms are:

● chronic pain all over the body

● fatigue

● memory problems

● sleep disturbances

● depression or anxiety.

How Does Physical Therapy Help?

Because of the wide range of symptoms, fibromyalgia can be a debilitating condition. It is not uncommon for people to begin avoiding activities altogether because of pain and fatigue. This begins a cycle of deconditioning that not only impacts the person’s overall health, but also makes the symptoms of fibromyalgia worse. The cause of fibromyalgia is currently unknown and there is no cure, so physical therapy treatments are designed to reduce and manage the symptoms. This requires a multi-pronged approach.

Common treatments include:

Education

The first step in treating fibromyalgia is often helping people understand what’s going on, and what they can do about it. Research has shown that people who are knowledgeable about their condition have better outcomes, more confidence, and cope better.

Decrease Pain and Improve Range of Motion

Physical therapists are movement experts with a lot of tools and techniques to help with the pain and stiffness caused by fibromyalgia. A PT might use gentle manual therapy or massage, prescribe specific stretches, or a simple yoga routine. They might also use modalities like electrical stimulation, biofeedback or in states where it is allowed, dry needling.

Exercise

Once patients understand the condition and are able to move a little better with less pain, exercise often enters the treatment picture. Research has shown that low to moderate intensity aerobic exercise like walking, biking, or swimming is important in managing fibromyalgia symptoms. It can help with pain, fatigue, sleep disturbances, depression, and more. Physical therapists and patients work together to find the right type of exercise and the right intensity to best manage fibromyalgia. They often have to start slow, and make adjustments along the way.

Each physical therapy session is tailored to the needs of the patient and will vary depending on the severity of their symptoms. Despite there still being no cure for fibromyalgia, physical therapists can help with pain management, strength, mobility, fatigue and function to help patients find relief from their symptoms.

A lady sleeping
The Importance of A Good Night’s Sleep

Written by Ashley Wood, PT, MPT

It is probably not news to many of you that sleep dysfunction has become a major problem in our country.  The CDC has reported that 70 million Americans have extreme sleep problems while almost 50% of Americans feel sleepy during the day, at least three days out of the week.  But, why is this such a big deal?

Why is sleep important?

Sleep is restorative and important for the function of all of our body systems.  We all know that when we do not get enough sleep it is harder to:
The Importance of A Good Night's Sleep
  • concentrate,
  • process information,
  • remember things,
  • and just overall makes us feel crabby.

But sleep affects many other areas of our bodies as well

The rise of chronic conditions in our country such as diabetes, obesity, IBS and other digestive problems, anxiety, depression, dementia, and Alzheimer’s disease have been linked to several lifestyle influences, including lack of good quality sleep.

The lack of sleep is also a driver of pain.  Of course being in pain can cause us to have difficulty with sleeping, but the reverse is also true.  Lack of sleep can:
  • increase our pain sensitivity,
  • decrease pain threshold,
  • and decrease our body’s natural endorphins that help with modulating pain.  

This is why we as physical therapists often educate our patients on sleep and ask questions to determine if there may be an undiagnosed sleep disorder present.  Getting a proper amount of sleep not only helps with the healing of your tissues after an injury, but also can affect the pain that you are experiencing related to that injury.

How much sleep should you get?  

It is recommended that the average adult get at least seven hours of sleep per night.

The Importance of A Good Night's Sleep

But, the quality of your sleep is just as important as the quantity of your sleep.

If you find yourself waking up several times per night or not feeling rested after getting the quantity of sleep needed, you are likely not getting good quality sleep.  If this is the case, it is important to speak with your health care provider to determine if there is an underlying cause for not getting good quality sleep or if there are things that need to be adapted with your sleep behavior to assist with getting a better night’s sleep.

How do we change our sleep patterns to ensure a better night’s sleep, both in quantity and quality?

Sleep hygiene is the term used to describe establishing good sleep habits.  Here are a list of tips for helping to establish good sleep hygiene:
1.  Go to bed and wake up at the same time every day.  This establishes a good circadian rhythm for your body and makes it more natural for your body (and brain) to relax and fall asleep.  Also, try not to nap during the day as this makes it more difficult to go to bed at a consistent time and to fall asleep at night.
2.  The bed should only be for sleep and sex.  We should not watch TV in bed, use our phones in bed, or work/do homework in bed.  If we are only using our beds for sleep and sex then when we get into bed, our bodies and brains become accustomed to relaxing in preparation for falling asleep.  Many experts also recommend that the bedroom itself be off limits for working and watching TV and only be a place for sleeping.
3.  Decrease the amount you are stimulated prior to going to bed.  Try to use the last hour before going to bed as a time for relaxation.  Put your phone away and turn off the TV.  You can read a book or practice mindfulness or other relaxation techniques.
4.  What if I wake up at night? If you wake up during the night, try some relaxation techniques such as progressive muscle relaxation, deep breathing exercises, or mindfulness to settle your body and brain.  If you are unable to fall back asleep, get out of bed and do something that is relaxing until you are feeling tired again.

As you can see, sleep is an important part of our daily lives, not just so we feel good but so our bodies can function properly.  The lack of sleep has increasingly become a problem in our country and has been linked to many chronic illnesses.

If you are having difficulty falling asleep or staying asleep, or just don’t feel rested after getting a proper amount of sleep, talk with your health care provider to see if there may be underlying issues contributing to poor sleep quality.  Changing sleep patterns can be difficult and takes time, but your body will thank you for it!