By: Dr. Richard DeFalco, DPT, OCS, CSCS, CWcHP, Cert. DN
The purpose of this months' article is to highlight some of the beneficial modes of treatment used to manage Fibromyalgia. Fibromyalgia syndrome (FMS) is a syndrome characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that FMS amplifies painful sensations by affecting the way your brain processes pain signals. The term central sensitization has been used to define the altered manifestation of pain in FMS. In other words, that brain has increased sensitivity to pain, causing pain to be felt with minimal activity/stress. Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event. Upon examination a patient is noted to have chronic widespread pain and tenderness in at least 11 of 18 predefined tender points. Ultimately, the syndrome is associated with effort intolerance, stress intolerance, and a hypersensitivity to pain, ultimately leading to varying levels of incapacitance.
Treatments range from pharmacological, activity management, stress management, behavioral therapy, biofeedback, passive treatments, and exercise therapy. The most successful outcomes are most often a result of a various treatment components.
The role of physical therapy in the management of FMS is aimed at desensitizing the central nervous system through a multi-modal approach that includes patient education, prescriptive exercise, and passive treatments (joint mobilization/manipulation, massage, electrical stimulation and dry needling to treat soft disuse dysfunction).
There is strong evidence that supports the use of aerobic exercise and strength training for the management of FMS. Poor physical fitness is common among those with FMS, ultimately leading to decreased functional mobility, decreased activity tolerance, and a declining quality of life, resulting in a perpetuating downward spiral. The goals of physical therapy would be to improve both the aerobic and strength capability of the body, thereby leading to improved overall activity level and decreased pain with activities of daily living. Through patient education, exercise, modalities, and activity modification, one can improve upon his/her ability to perform normal routine tasks.
Passive treatments (as listed above) are meant to activate pain inhibiting mechanisms in the body that aid in desensitize the central nervous system. It should be noted that these passive treatments are not the primary focus, but rather an adjunct, of a comprehensive program aimed at addressing the symptoms. Long-term success is dependent on an active engagement in the performance of a home exercise program that is tailored to the individual.
Constant communication between the patient and therapist is essential towards a successful outcome. Since activity induced pain is common in patients with FMS, a carefully graded progressive exercise program that is based on reasonable goals and the patient's limitations/resources is critical. Physical therapists are experts as instituting prescriptive exercise for neuromusculoskeletal disorders. Even more so, physical therapists that have achieved specialty certifications in the area of musculoskeletal dysfunction can offer an additional level of confidence/expertise. We at Professional Rehabilitation Services have physical therapists that have achieved just that.
At Professional Rehabilitation Services we pride ourselves in distinction, and one of our Board Certified Orthopedic Physical Therapists will pursue an individualized treatment approach to your needs. Less than 5% of physical therapists in South Carolina are board certified in orthopedics. All physical therapists at Professional Rehabilitation Services are board certified. So if you or someone you know is having neuromusculoskeletal pain and/or suffers with Fibromyalgia Syndrome and would like to know more about physical therapy options, seek the consultation of a physical therapist at one of our three locations or see your physician for a referral to one of our facilities.
At Professional Rehabilitation Services, we treat a wide variety of neuromusculoskeletal conditions using the latest in evidence based therapies provided by highly credentialed physical therapists. In addition to being licensed physical therapists, our providers have additional specialty certifications and training in orthopedics, manual therapy, sports, strength and conditioning, vestibular treatment, and dry needling. For further information on this or other related topics you can contact Brian P. Kinmartin PT, DPT, MTC, OCS, STC, CWcHP, Cert. DN, (Pawleys Island) (843) 235-0200, Richard A. Owens, PT, MS, OCS, Cert. SHT, CWcHP, Cert DN (Surfside) (843) 831-0163 at Professional Rehabilitation Services, Richard DeFalco, DPT, OCS, CSCS, CWcHP, Cert. DN (Myrtle Beach) (843) 839-1300, or visit our website at www.prsrehabservices.com where you can learn more about the company and even download a referral form for you physician to fill out. You can also call and schedule a free 15 minute consultation!