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Fibromyalgia: An Interesting Version of Chronic Pain

You may have heard of a condition known as Fibromyalgia or know someone who has been diagnosed with this condition. You may also be confused as to what it is exactly. Well, you're not alone with this confusion. Fibromyalgia Syndrome (FMS) is not straight forward, experts are still learning and there continues to be significant variability in the presentation of FMS. Typical symptoms include widespread pain, tender points above and below the waist and on both sides of your body without a particular pain pattern. This pain has typically been present for many years and commonly associated with other symptoms and conditions such as fatigue, significant sleep disturbances, depression, anxiety, morning joint stiffness, irritable bowel syndrome and tension headaches.

Fibromyalgia can develop on it's own, however it is often triggered by a physically or emotionally traumatic event such as, motor vehicle accidents, physical, verbal and/or sexual abuse. There is some evidence for genetic predisposition, however a lot more research needs to be done in this area. One of my teachers once told me that our physical body cannot, and will not, lie. Emotional and physical stress can trigger a host of health problems and fibromyalgia is physical proof of this concept. In the past, many health care professionals believed this condition was mainly/ only due to psychological distress which meant that many people suffering were ignored or not treated properly. Advances in research now suggest that FMS is a real neurosensory disorder associated with abnormal sensory and pain processing in the brain (& spinal cord). FMS is starting to be taken more seriously, acknowledging that even though there may not be any physical tissue damage present, this widespread pain is REAL and actually very interesting. We now know a bit more, which means people with FMS are beginning to receive the proper help they require instead of being dismissed.

As a physiotherapist working in chronic pain, it is an honor when someone with FMS comes to me for help. Looking for assistance is the first sign of wanting to feel better and actually making that initial appointment with a health care professional is a huge first step in the healing process. Treatment for Fibromyalgia usually involves a multidisciplinary approach. Active-based physiotherapy is one of the most critical components of every FMS patient's treatment and this is where I would like to highlight the attention of this post.

There is evidence demonstrating that aerobic exercise (ex. swimming, walking, cycling etc) and strength training reduces pain, tenderness and depression in those with FMS, as well as improve sleep quality, self-efficacy and overall quality of life. Also, remember that aerobic exercise stimulates the release of our body's natural pain killers, this is where the term "Runners high" comes from. So on top of all the health benefits, aerobic exercise directly reduces pain through activating endorphin release. Endorphins travel to your brain and essentially reduce our perception of pain. You do not need to run a marathon either for this process to initiate, research has shown that a threshold of over 10 minutes of continuous movement at a moderate intensity is enough to trigger exercise analgesia (pain relief through exercise).

According to the American College of Sports Medicine, exercise prescription for healthy adults generally applies to individuals with Fibromyalgia and should be encouraged. The difference being, that symptoms of pain and fatigue are closely tracked because these are associated with the ability to exercise productively. Also, progression of exercise is slower to enable long term exercise adherence and minimize exacerbation of symptoms.

In Summary, if you suffer from Fibromyalgia, don't let this hold you back from doing the things you enjoy doing. It is common to feel fearful of exercise or regular activities, however you should know that there is always a way to properly and safely begin regular exercise. This will actually enable you to move more and feel better, and then move even more and feel even better in your everyday life!

If you have questions about getting started with an exercise program (What type of exercise? When and how often? How many reps? How do I know I'm not making my pain worse? What should I avoid? Etc etc...) please feel free to email me. I would be delighted to help you begin your journey towards living the life you deserve <3

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Jan 28, 2021

Sadly the primary approach to managing most people with persistent pain is through medications... not that medications are not sometimes valuable, they should be an adjunct and not the primary treatment.

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