FIBROMYALGIA

Fibromyalgia is a chronic tender point disorder in muscles, tendons and ligaments throughout the whole body. There are 18 tender points at various locations including head, shoulder, chest, elbow, knee, and hip. Patient experiences pain when we press the tender points around the joints. Other than deep muscle pain few other symptoms are also associated with fibromyalgia like fatigue, sleep problems and irritable bowel.

Possible causes and predisposing factors:

• Post traumatic stress disorder-any physical or emotional trauma
• Associated with diseases like autoimmune diseases, arthritis etc
• Anxiety and depression-fibromyalgia is often associated with anxiety and mood disorders.
• Gender- more common in females as compare to males.
• Genetics- fibromyalgia can be hereditary also.

Symptoms of fibromyalgia

• Pain – pain in muscles, tendons and ligaments throughout the whole body .Nature of pain is deep and dull aching pain which worsens after a physical activity and as the day progresses.
• Trigger or Tender points- 9 pair of tender points:

1. Both sides of the back of the head
2. Both sides of the neck
3. Top of each shoulder
4. Shoulder blades
5. Both sides of the upper chest
6. Outside of each elbow
7. Both sides of the hips                
8. Buttocks                                 
9. Insides of the knees

• Other symptoms are:

1. Restless leg syndrome (RLS)
2. Sleep problems
3. Irritable bowel

If patient experiences above mentioned pain for at least three months, possible reason is fibromyalgia.

Treatment

Medical treatment-includes various types of drugs like NSAIDs, Anti – depressants.

Other natural and alternative treatments-include acupuncture, yoga, meditation and balanced diet etc

Physical therapy- Physical therapy treatment can be categorized as:

• Electrotherapy treatment

Aim of electrotherapy treatment is:

Reduce pain and muscle spasm

Accelerate healing

Modalities used are:

TENS

Ultrasound

• Physical treatments:

Aim of physical treatment is:

Improve the flexibility of muscle and joint

Improve healing

Decrease swelling

Physical Treatment:

Hot packs or ice packs

Hydrotherapy

Paraffin wax bath

• Manual treatments:

Aim:

Improve ROM

Reduce swelling and pain

It includes manual therapy like:

Massage

Stretching and mobility exercises

Other measures:

Postural muscles strengthening and modifications for reduction of load o affected muscle group. Regular exercise program designed to improve the aggravating symptoms.