Fibromyalgia Rehabilitation

Fibromyalgia Rehabilitation

The Physical Medicine and Rehabilitation Physician ... Adding Quality to Life

Advanced Medical Rehabilitation Group
Gary DiBlasio, M.D., P.A.
701 Northlake Boulevard North Palm Beach, FL 33408 ● Suite 208

1807 South Kanner Hwy, Stuart, FL 34994

Voice: (561) 863-2828 ● Fax: (561) 863-2914

Dedicated to the state-of-the-art non-invasive medical treatment of spine and pain disorders.

What is fibromyalgia?

Fibromyalgia is a chronic disorder that causes widespread pain and tenderness in the muscles and soft tissue (including tender points) as well as sleep problems, fatigue, and a variety of other symptoms. These problems can be severe enough to disrupt a person's work and daily activities. Fortunately, the condition does not permanently damage the muscles, joints, or internal organs.

Fibromyalgia is a syndrome of chronic pain, not a disease or a psychological disorder.

Tender points are specific sites on the body that cause pain when pressed. The pain may spread when a tender point is pressed and cause pain in a larger area (for example, down the leg, arm, or back).

Tender points are specific sites on the body that cause pain when pressed. The pain may spread when a tender point is pressed and cause pain in a larger area (for example, down the leg, arm, or back).

There are 9 pairs of tender points. Each pair has one point on each side of the body, for a total of 18 points. These pairs are located:

  1. Just behind the ear where the neck muscles attach to the base of the skull.
  2. About halfway between the base of the neck and the tip of the shoulder.
  3. At the spot where the back muscles attach to the shoulder blade, just below the second tender point.
  4. On the front of the neck above the collarbone.
  5. Just to the right and left of the breastbone (sternum) about 2 in.(5.08 cm) below the collarbone.
  6. On each forearm just below and to the outside of the crease of the elbow.
  7. Just above and to the outer right and left of each buttock.
  8. On the outer upper leg just behind the bony part of the hip (this point is easier to find when standing).
  9. On the inside of each knee.

To clearly diagnose fibromyalgia, a person must have pain at 11 or more of the 18 tender points. In practice, however, many people with fibromyalgia have fewer than 11 tender points.

The variety and severity of symptoms caused by fibromyalgia vary from person to person.  Widespread, chronic pain is the most common symptom. It usually develops gradually.

Other symptoms that commonly occur in addition to pain include:

  • Fatigue that interferes with work and daily activities.
  • Sleep problems (difficulty falling or staying asleep, waking up feeling tired).

Less commonly people with fibromyalgia may have:

  • Morning stiffness lasting less than an hour.
  • Headaches.
  • Constipation or diarrhea related to irritable bowel syndrome.
  • Memory problems and difficulty concentrating.
  • Numbness or tingling in the hands and other parts of the body. The skin may be ultrasensitive, reacting to a firm touch with tingling, numbness, or a "pins and needles" sensation.
  • A circulatory problem that affects the small blood vessels of the skin (Raynaud's phenomenon).
  • Anxiety or depression.

No one has a clear understanding of what causes fibromyalgia. There are theories as to what may cause it, but there is not enough evidence to support any single theory. Since fibromyalgia is a syndrome of many symptoms, it has been difficult to find a specific cause for the combined symptoms. It has been recognized as a medical disorder only since the 1980s.

Some theories suggest that fibromyalgia may be:

  • Associated with oversensitive nerve cells in the spinal cord and brain. Oversensitivity may occur as a result of changes in chemicals in the brain or spinal cord that regulate pain. As a result, the person senses pain more easily, and widespread muscle pain occurs.
  • Linked to an imbalance in brain chemicals that control mood, which results in a lowered tolerance for pain and may also cause an unrestful sleep cycle and fatigue. Once this occurs, a person becomes less physically active, and the muscles and tissues become more sensitive and painful and more easily irritated.
  • Caused by an imbalance of hormones such as cortisol and growth hormone. Their release is controlled by the pituitary gland and the hypothalamus. Imbalances of these hormones can result in fatigue, mood changes, concentration and memory difficulties, a lowered tolerance for pain, and other symptoms.

Currently, there is no cure for fibromyalgia. Treatment is focused on managing pain, fatigue, depression, and other symptoms common in fibromyalgia in an attempt to break the cycle of increased sensitivity to pain and decreased physical activity.

Treatment may include:

  • Medications to help you sleep better, such as tricyclic antidepressants, SSRIs, or cyclobenzaprine (Flexeril).
  • Medications to relieve muscle and joint pain, such as tricyclic antidepressants, cyclobenzaprine (Flexeril), or, less often, nonprescription pain relievers.
  • Exercise therapy to relieve sore muscles and increase energy.

Other Treatment

A variety of other treatments have been used to treat conditions that cause chronic pain. Most of these complementary or alternative therapies are not proven treatments for fibromyalgia, but they may be helpful when symptoms flare up and may improve quality of life. Safe complementary therapies such as acupuncture or massage, for instance, may help relieve stress, ease muscle tension, and help you feel better and healthier.

Other Treatment Choices

Other treatments that may be used to treat fibromyalgia include:

  • Physical therapy.
  • Massage therapy.
  • Injection of tender points with a numbing drug (anesthetic).
  • Cognitive-behavioral therapy and other forms of counseling.

Those treatments should be coordinated through a Physiatrist who has extensive training and experience with this disorder
 
     
 
     

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