Physical Therapy for Fibromyalgia

Kelly Rehan
Medical Writer
SpineUniverse
Wheaton, IL

Physical therapy often takes a hands-on approach, which may make you cringe if you're experiencing pain from multiple hypersensitive tender points. However, physical therapy uses methods that are gentle, effective, and will most likely play a major role in managing your fibromyalgia symptoms.

There are a variety of physical therapy techniques. Passive treatments relax your body and include deep tissue massage, heat and cold therapy, hydrotherapy, TENS (transcutaneous electrical nerve stimulation), and ultrasound.

Your physical therapy program will usually begin with passive treatments. When you feel ready, you will start active treatments that strengthen your body and prevent further fibromyalgia pain. Your physical therapist will work with you to develop a plan that best suits you.

Passive Treatments

  • Deep Tissue Massage: Unless you're in an extreme amount of pain, deep tissue massage is an ideal fibromyalgia treatment because it uses a great deal of pressure to relieve deep muscle tension and spasms. Spasms prevent muscle motion at the affected level, which is one of the reasons people with fibromyalgia experience a decreased range of motion. Physical therapy techniques, including deep tissue massage, will help you use your muscles more effectively. This treatment may be combined with heat or cold therapies to boost the benefits.
  • Heat Therapy: Heat therapy is one of the most preferred methods of reducing chronic aches and pains associated with fibromyalgia. Heat triggers the body's natural healing process by relaxing your muscles and speeding up blood flow to the affected area. Extra blood delivers extra oxygen and nutrients. Blood also removes waste byproducts from muscle spasms.

    Heat may not completely eliminate the source of your pain, but it can effectively reduce your pain. This therapy is used in a couple of ways—through dry heat (a heating pad or a dry, hot towel) or moist heat (steam heat or a moist, warm cloth).

    When using heat therapy on your own after physical therapy ends, never overheat painful areas. If you're using a heating pad, set it to low or medium. When using a hot towel, touch it first to make sure it's not too hot. Excessive heat may not only exacerbate your fibromyalgia pain but also potentially cause burns.
  • Cold Therapy: While heat therapy best reduces chronic pain, cold therapy (also called cryotherapy) eases inflammation and acute pain from tender points. Cold therapy slows circulation, which reduces swelling. Your physical therapist may place a cold compress on the target area, give you an ice massage, or even use a spray known as fluoromethane to cool enflamed tissues. Both heat and cold therapies offer their own set of benefits, and your physical therapist may alternate between them to get the best results.
  • Hydrotherapy: As the name suggests, hydrotherapy involves water. As a passive treatment, hydrotherapy may simply involve sitting in a whirlpool bath to relieve pain, relax muscles, and condition your body without adding unnecessary stress.
  • TENS (transcutaneous electrical nerve stimulation): A TENS machine uses an electrical current to stimulate your muscles. It sounds intense, but it really isn't painful. Electrodes taped to your skin send a tiny electrical current to key points on the nerve pathway. TENS reduces muscle spasms and is generally believed to trigger the release of endorphins, which are your body's natural pain killers.
  • Ultrasound: This therapy uses sound waves to create a gentle heat that increases blood circulation to your deep tissues. Ultrasound helps reduce muscle spasms, inflammation, stiffness, and pain and is most effective in relieving range of motion limitations in chronic pain sufferers, as opposed to those with acute inflammatory conditions.

    • Active Treatments
    Active treatments help address core stability, flexibility, strength, and joint movement. An exercise program may also be prescribed to achieve optimal results. This will not only curb recurrent pain but will also benefit your overall health. Your physical therapist will work with you to develop a program based on your specific symptoms and health history.

    Active treatments include:

    • Core stability: Your core (abdominal) muscles have a greater impact on your overall health than you may think. Strong core muscles serve as good allies to your back muscles in supporting your spine. It's called the core because it's the central powerhouse of your body. Naturally, a healthy core provides your body with a strong, stable center point.
    • Muscle flexibility and strengthening: Your range of motion will likely be restricted if you're experiencing fibromyalgia pain. Using customized stretching and strengthening exercises, your physical therapist will help you lengthen and strengthen your muscles, and improve joint movement. Strong, lean muscles better handle pain.
    • Hydrotherapy: Water-based exercises may be recommended to provide gentle aerobic conditioning.

    Your physical therapist will teach you "self-care" principles so you understand how to best treat your symptoms. The ultimate goal is for you to develop the knowledge to help control your symptoms. It's essential that you learn the exercises and continue them after the formal therapy ends. If you fail to keep with a fitness regimen, you won't enjoy long-term results from your physical therapy. By taking care of your back on your own, you'll reduce further fibromyalgia pain.

    Last Updated: 04/02/2009
    Continue Reading: How Psychologists Help Fibromyalgia Patients
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