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The Therapist Is In...Fight fibromyalgia with fitness

The Therapist Is In...
Fight fibromyalgia with fitness
by Shannon Murphy, MPT
Monthly Contributing Writer

Chances are, at some point in your life, you've hurt all over. Maybe it was a bad flu, a car accident, or a long day of strenuous work. Most people have had "one of those days", and for most people those pains go away with time. But happens when they don't? What if your body just continues to hurt? For millions people in the US, they eventually get a diagnosis of "fibromyalgia" - a word meaning, literally, 'pain of the connective tissue and muscle'.
Is "fibro" real?
Fibromyalgia has a complicated history in the medical field. The syndrome has typically been one of exclusion, meaning that when other diseases can't be found to explain the symptoms, the label of fibromyalgia is often applied. Some doctors and practitioners have admitted to "not believing" in the existence of fibromyalgia, and not all physicians have applied the diagnosis in the same way. As a result, many patients have drifted around the medical system without consensus on their condition or treatment. Science is changing that, however, and there is solid evidence of abnormalities in the central nervous system (your spinal cord & brain) that make fibromyalgia a very real, if frustrating, condition.
What are the symptoms?
The American College of Rheumatology (ACR) boils diagnosis down to a couple of key features:
* Widespread pain (R, L, upper, lower & spine) lasting > 3 months and not explained by any other diagnosis
* Tenderness at 11/18 specified points
These findings are usually accompanied by other complaints including:
* Poor sleep
* Fatigue & mental fog
* Anxiety & depression
* Headaches, dizziness, tingling, and abdominal pain.
The severity of these symptoms can vary depending on the weather, stress, physical activity or even the time of day. Fibromyalgia is not a progressive or fatal condition, but requires long-term management. It is more common in women than men, and more common among middle and older-aged individuals.
What causes fibromyalgia?
In a nutshell, the nervous system becomes hypersensitive and starts responding to signals incorrectly. The exact reason for this remains unclear. There is some evidence that genetic factors play a role to pre-disposition and various stressors can trigger the onset (like physical trauma, illness, or severe stress). The field of pain science is uncovering new information about the chemistry of chronic pain that may lead to better understanding of why fibromyalgia develops in the first place.
How is fibromyalgia treated?
Treatment generally involves some combination of medications to assist with pain management, sleep, and depression. Exercise, however, is a cornerstone of successful pain management. Appropriate, regular exercise decreases pain, improves mood, and can promote more restorative sleep. It is important for individuals with chronic pain to learn that movement is not dangerous, since lack of activity makes symptoms worse and lead to other medical problems (like heart disease and diabetes).
How does exercise help?
Exercise improves pain & function by accomplishing many things:
* Increasing oxygen delivery to the tissues & nervous system, which decreases pain
* Promoting chemical release in the brain that can improve mood and sleep
* Improving strength and fitness that limits the development of other health problems (like heart disease or diabetes)
* Establishing a successful habit of movement that improves self-efficacy (a feeling that you have some control over your life)s
What type of exercise is best?
* The best exercise is one that you enjoy. You should feel successful but slightly challenged. There is no research consensus on a single "best" form of exercise, but most studies find benefit from a combination of:
* Low impact aerobic exercise (gentle dance, cycling, treadmill)
* Breathing/meditation
* Low-to-moderate level strength training
* Flexibility exercise (unless you are too flexible to begin with)
* Aquatic exercise & swimming
* Lifestyle physical activity (walking, gardening, etc)
The key to exercising successfully with fibromyalgia is to start easy and progress slowly. If you are completely new, start with 15-20 min of low-intensity from the categories above and repeat 2-3x / week for 2 weeks. If you are able tolerate that without setbacks, gradually increase the duration, intensity and variety of your exercise. It is important to tailor the program to your specific issues and address new pains/issues early before they start to interfere - consult your physician & physical therapist for specific recommendations.

This series of columns are by Shannon Murphy, MPT, Owner/Director of BodySense PT. 9 Saint Paul St, 3rd Floor, Boonsboro, MD 21713. 301-432-8585 phone, 301-432-1987 fax,

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