Wednesday, May 31, 2017

PT Pathologies: Fibromyalgia

Fibromyalgia is an incurable disease affecting over 6 million people.  In fact, while hard to diagnose, it is the most common disorder of the musculoskeletal system in the United States.  This disease is a life long illness that is managed best with a multidisciplinary approach.  The cause of fibromyalgia is unknown however researchers believe it is related to an increase in a chemical in the body, substance P, which transmits pain.  Fibromyalgia requires care focused on muscle weakness, pain, and fatigue.

While diagnosis of the disease is difficult there are standardized criteria set forth in order to establish a diagnosis and they include:  pain in at least 11 of 18 "tender point" sites, widespread pain located in all 4 quads of the body, having pain lasting greater than 3 months, lab work establishing substance P fluctuations, testing of tender points with a Dolorimeter and the use of diagnostic tools such as a Fibromyalgia Impact Questionnaire.  Once diagnosed, treatment and management can begin.

A multidisciplinary approach is most effect and should only require medication as needed.  Education, psychotherapy and exercise are all required.  Physical therapy intervention includes a variety of treatments to assist a person with pain such as: aquatic therapy, relaxation techniques, yoga, energy conservation, proper body posture mechanics, ultrasound, TENS, hydrotherapy, and exercises.  In accordance with the patient's fatigue, exercise should be to toleration and start with short sessions primarily in the morning to loosen joints and assist with mobility.  Physical therapy can provide improvement for a person struggling with fatigue, muscle weakness and pain.

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