Fibromyalgia is a soft tissue syndrome that causes widespread unrelenting pain and enhances the patient’s perception of pain. The underlying concept is that the autonomic nervous system, responsible for the ‘rest and relax’ response, is dysfunctional. This results in ineffective pain modulation, causing continuous overactivation of the systemic nervous system (fight or flight response). The result of this distortion is a widespread sensation of pain with a decreased tolerance to sensory input. The immune system is also heightened resulting in widespread inflammation.
In a nutshell, FMS is a deregulation of neurologic, immunologic, endocrinological and enteric systems. The most common reported symptoms are:
Muscle pain and tender points
- Visual problem
- Mental and physical fatigue
- Morning stiffness
- Global anxiety
- Cognitive and memory problems
- Headaches
- Irritable Bowel Syndrome
- Dry eyes and mouth
Fibromyalgia or FMS (fibromyalgia syndrome) is a complex syndrome, which requires many facets to be addressed in pain management. Classically FMS tends to be seen more in women.
We are unsure of what the underlying causes of FMS are. Some believe it is an autoimmune disease triggered by the environment such as stress, illness or trauma. We also know that these can also exacerbate pain and cause ‘flare ups’.
- Stress
- Trauma
- Overtreatment/Overstretching
- Cold weather or changes in barometric pressure
Due to its complexity, fibromyalgia requires a multifaceted treatment approach. A person with fibromyalgia will see many practitioners to address the different facets of the condition, this may include their GP, Rheumatologist, Psychologist and manual therapists including, Exercise Physiologist, Chiropractor, Physiotherapist and/or Massage Therapist. At Bare Motion, we follow the American Pain Society Guidelines for Fibromyalgia Management. The APS splits the management into pharmacologic and non-pharmacologic. Bare Motion, as an integrated and allied health practice will work closely, with your GP’s and specialists to manage the non-pharmacologic side of treatment. Unfortunately, there is no cure for fibromyalgia however, our team of practitioners will strive to find the best management for you and your symptoms. There is considerable evidence to support education on pain management and self-management programs, and for aerobic exercise within your limits. There is moderate evidence to support muscle strengthening programs and clinician assisted treatments such as chiropractic manipulation and therapeutic massage (helpful for pain relief due to analgesic effects). The best evidence supports a multidisciplinary approach that involves two or more strategies aiming to decrease pain and improve function.
At Bare Motion we can help to tailor a specific exercise program encouraging aerobic fitness and building muscle strength. This will also involve working on self-regulation techniques (described below). Our integrated approach also allows the involvement of manual therapists including Chiropractors, Physiotherapists and Remedial Massage. Each of these modalities are aiming to decrease your pain and improve function, by working towards your fitness and pain goals we hope to improve your everyday life!
- This is where patients learn self-regulating techniques to help them cope with flare-ups. These could be:
- Progressive muscle relaxation techniques
- Breathing exercises
- Changing fear avoidance techniques
- Pain goal setting
- Reduction of catastrophic thinking
- How to engage with your pain
- Attention diversion strategies
- Relapse prevention strategies
It has been found that self-regulation and emotion have a large impact on pain perception. Setting goals that are not dependent on social factors, deemed persons more ‘self-sufficient’. For example, if a person’s pain goal was ‘all I want is for someone to believe I have a genuine problem’ or ‘I am looking for a practitioner who will relieve my pain’ then ‘..the stage is set to increase dependency and personal distress’. In contrast, those whose goals were set to ‘get on with life despite fibromyalgia’ had an improved pain experience with less personal distress.
If you would like more info on self-regulation techniques not only for fibromyalgia patients but for any chronic pain patients, visit Black Swan Health.
If you would like to know more about how we can help with your pain management, self-regulation and exercise program please call us today on (08) 9284 6662 or book in with one of our friendly practitioners.