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December 23, 2024
13 min read
M.O. Therapy Team
Pain Management

Fibromyalgia Management: A Multidisciplinary Approach

Comprehensive guide to fibromyalgia management including exercise, physiotherapy, and lifestyle strategies for chronic pain relief.

fibromyalgiachronic painfatigue managementexercise therapypain relief

Fibromyalgia is a complex chronic condition characterized by widespread pain, fatigue, and other challenging symptoms. While there is no cure, effective management strategies can significantly improve quality of life. At M.O. Therapy in Markham, we provide compassionate, evidence-based care to help patients with fibromyalgia manage their symptoms and live fuller lives.

Understanding Fibromyalgia

What Is Fibromyalgia?

Fibromyalgia is a chronic condition affecting the nervous system's pain processing, resulting in amplified pain sensations throughout the body.

Key Features:

  • Widespread musculoskeletal pain
  • Fatigue and sleep disturbances
  • Cognitive difficulties ("fibro fog")
  • Heightened pain sensitivity (central sensitization)
  • No structural damage to tissues

Prevalence

  • Affects 2-4% of the population
  • More common in women (7:1 ratio)
  • Usually develops between 30-50 years
  • Can affect anyone at any age

Symptoms

Primary Symptoms:

  • Widespread pain (both sides of body, above and below waist)
  • Chronic fatigue
  • Sleep problems (unrefreshing sleep)
  • Cognitive difficulties

Associated Symptoms:

  • Headaches
  • Irritable bowel syndrome
  • Temporomandibular disorder
  • Anxiety and depression
  • Numbness and tingling
  • Sensitivity to temperature, light, sound

Causes

The exact cause is unknown, but contributing factors include:

Central Nervous System:

  • Altered pain processing
  • Central sensitization
  • Neurotransmitter imbalances

Triggers:

  • Physical trauma
  • Emotional stress
  • Infections
  • Genetic predisposition
  • Hormonal factors

Diagnosis

Diagnostic Criteria

Fibromyalgia is diagnosed based on:

  • Widespread pain for 3+ months
  • Pain in multiple body regions
  • Severity of fatigue, sleep, and cognitive symptoms
  • No other explanation for symptoms

What to Expect

  • Thorough medical history
  • Physical examination
  • Blood tests (to rule out other conditions)
  • No specific test for fibromyalgia

Treatment Approaches

Multidisciplinary Management

Best results come from combining:

  • Exercise and physical activity
  • Physiotherapy
  • Medication (when appropriate)
  • Psychological support
  • Lifestyle modifications
  • Patient education

Exercise Therapy

Why Exercise Matters:

Exercise is one of the most effective treatments for fibromyalgia:

  • Reduces pain levels
  • Improves sleep quality
  • Increases energy
  • Reduces depression and anxiety
  • Improves physical function
  • Enhances quality of life

Starting Exercise:

The key is starting slowly and progressing gradually:

  • Begin below current tolerance
  • Progress very gradually (10% per week maximum)
  • Expect some temporary increase in symptoms initially
  • Consistency more important than intensity
  • Any movement is beneficial

Types of Beneficial Exercise:

Aerobic Exercise:

  • Walking
  • Swimming or water aerobics
  • Cycling
  • Low-impact aerobics
  • Start with 5-10 minutes, build to 30 minutes

Strength Training:

  • Light resistance training
  • Start with body weight or light weights
  • Focus on major muscle groups
  • 2-3 times per week

Flexibility:

  • Gentle stretching
  • Yoga (gentle/restorative)
  • Tai Chi
  • Improves mobility and reduces stiffness

Water-Based Exercise:

  • Warm water pool therapy
  • Reduces joint stress
  • Often well-tolerated
  • May be easier to start with

Physiotherapy

Benefits:

  • Individualized exercise prescription
  • Manual therapy for specific pain areas
  • Education about pacing and activity management
  • Guidance on symptom management

What We Offer:

  • Comprehensive assessment
  • Customized exercise program
  • Gentle manual therapy
  • Education and support
  • Pacing strategies

Massage Therapy

Benefits:

  • Pain relief
  • Reduced muscle tension
  • Improved sleep
  • Relaxation
  • Stress reduction

Considerations:

  • Gentle pressure recommended
  • Communication with therapist essential
  • May need modified approach
  • Regular sessions more beneficial

Psychological Support

Cognitive Behavioral Therapy (CBT):

  • Addresses pain-related thoughts
  • Develops coping strategies
  • Improves sleep hygiene
  • Reduces anxiety and depression

Mindfulness:

  • Meditation
  • Breathing exercises
  • Body awareness
  • Present-moment focus

Stress Management:

  • Relaxation techniques
  • Time management
  • Boundary setting
  • Support systems

Lifestyle Management

Sleep Hygiene

Good sleep habits are essential:

  • Consistent sleep schedule
  • Comfortable sleep environment
  • Limit caffeine (especially afternoon/evening)
  • Avoid screens before bed
  • Relaxation routine before sleep
  • Address sleep disorders if present

Pacing

Activity Management:

  • Balance activity and rest
  • Break tasks into smaller portions
  • Plan for rest periods
  • Avoid boom-bust cycle
  • Listen to your body
  • Prioritize important activities

Stress Reduction

  • Identify stress triggers
  • Develop coping strategies
  • Practice relaxation daily
  • Set realistic expectations
  • Learn to say no
  • Build support network

Diet and Nutrition

General Recommendations:

  • Balanced, nutritious diet
  • Stay hydrated
  • Some benefit from anti-inflammatory diet
  • Limit processed foods
  • Consider food sensitivities
  • Regular mealtimes

Exercise Program for Fibromyalgia

Starting Point

Assessment:

  • Current activity level
  • Symptom severity
  • Physical limitations
  • Goals and preferences

Initial Program:

Week 1-2:

  • 5-10 minute gentle walking daily
  • 5 minutes of gentle stretching
  • Focus on establishing routine

Week 3-4:

  • 10-15 minute walking
  • Add 2-3 strength exercises
  • Continue stretching

Month 2:

  • 15-20 minute aerobic activity
  • Gradual strength progression
  • Maintain flexibility work

Sample Exercise Routine

Daily (or most days):

  • 5-10 minute walk (build gradually)
  • Gentle stretching (5-10 minutes)

3 Times Weekly:

  • Aerobic activity (build to 20-30 minutes)
  • Light strength training:
    • Wall push-ups: 2 sets of 10
    • Squats or chair stands: 2 sets of 10
    • Arm exercises: 2 sets of 10

Daily:

  • Relaxation/breathing (10-15 minutes)

Managing Flares

During Flares:

  • Reduce activity but don't stop completely
  • Gentle movement is beneficial
  • Water walking or stretching
  • Focus on relaxation
  • Gradual return to baseline

Working with Healthcare Providers

Building Your Team

Consider involving:

  • Primary care physician
  • Physiotherapist
  • Massage therapist
  • Psychologist/counselor
  • Rheumatologist (if needed)
  • Sleep specialist (if sleep issues significant)

Communication

  • Keep symptom diary
  • Track what helps and what doesn't
  • Be honest about challenges
  • Ask questions
  • Set realistic goals together

Treatment at M.O. Therapy

Physiotherapy

Our physiotherapists provide:

Assessment:

  • Comprehensive evaluation
  • Functional assessment
  • Goal setting
  • Treatment planning

Treatment:

  • Individualized exercise program
  • Gentle manual therapy
  • Education and support
  • Pacing strategies
  • Ongoing guidance

Massage Therapy

Our RMTs offer:

  • Gentle therapeutic massage
  • Pain management techniques
  • Relaxation promotion
  • Individualized approach

Chiropractic Care

May include:

  • Gentle assessment
  • Soft tissue therapy
  • Movement optimization
  • Supportive care

Frequently Asked Questions

Can exercise make fibromyalgia worse? Exercise can temporarily increase symptoms, especially when starting, but over time it reduces pain and improves function. The key is starting very slowly and progressing gradually.

What is the best exercise for fibromyalgia? There's no single best exercise—the best exercise is one you'll do consistently. Water-based exercise, walking, and gentle yoga are often well-tolerated starting points.

How long before exercise helps fibromyalgia? Most people begin to notice improvements after 4-8 weeks of consistent exercise. Full benefits may take 3-6 months. Persistence is key.

Should I exercise during a flare? Yes, but modify your activity. Gentle movement like walking or stretching is beneficial even during flares. Complete rest often prolongs symptoms.

Book Your Assessment

If you have fibromyalgia and want support developing an effective management strategy, M.O. Therapy in Markham can help. Our compassionate team understands chronic pain and will work with you to improve your quality of life.

Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.

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