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Treatment Options
Because the symptoms of fibromyalgia wax and wane, treatment
(as with that of other chronic diseases) should be
considered an ongoing process rather than management of a
single episode. Flare-ups often exacerbate the client’s
underlying stress. Furthermore, stress can also precipitate
flare-ups of fibromyalgia.
The first line of
defense for relieving basic fibromyalgic symptoms should be
body therapy and exercise.
Although pain from this condition primarily manifests in
specifically designated areas, the trained manual therapist
refrains from “chasing the pain” and instead, seeks to
restore whole body function by testing for ART:
- asymmetry
- restriction of motion
- and tissue texture abnormality
Postural evaluations using Vladimir Janda, M.D.’s Upper
and Lower Crossed Syndromes (see Figure 1) have
proven extremely beneficial in identifying asymmetrical
muscle imbalance patterns that exasperate fibromyalgic
symptoms.
Specific hands-on techniques that lengthen tight,
neurologically facilitated muscles and Tone, inhibited
muscles helps restore balance and symmetry while fighting
off the compressive forces of gravity.
Tissue texture abnormalities must be closely evaluated in
clients presenting with fibromyalgic symptoms. Boggy,
leathery, fibrotic, contractured, and spasmodic tissues are
potential pain generators, with each requiring a uniquely
different hands-on approach.
Post isometric relaxation routines such as those
demonstrated in Figures 2 and 3 prove very beneficial
in recovering lost range of motion to fibrotic spine related
tissues such as joint capsules, ligaments, and paravertebral
myofascia.
Any deep tissue technique that calms central nervous
system hyperactivity and lowers sympathetic tone will
greatly benefit those with fibromyalgia.
While it is tempting for the client to relax and not move
joints and muscles that are hurting, moving them is one of
the best preventive and curative measures found so far to
alleviate the painful symptoms.
Traditional massage techniques are helpful in desensitizing
hyperexcited cutaneous (skin and fascial) neuroreceptors.
However, deep-tissue techniques that incorporate active
client movements (enhancers) during the hands-on work add
additional therapeutic power by calming pain generating
articular (joint) receptors. Intrinsic muscles and joints
are inseparable; what affects one always affects the other.
Therefore, a more holistic approach to treating
fibromyalgia and myofascial pain syndromes should include
soft-tissue techniques that create extensibility in
contractured tissues; tonify weak muscles; and decompress
impacted, motion-restricted joints and their supporting
ligaments.
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Figure 1. Tender point therapy
must be accompanied by postural corrections using Vladimir
Janda’s unique muscle-balancing formula. Following postural
evaluation, specific deep tissue, assisted stretching, and
myoskeletal routines help restore symmetry, strength, and
pain-free range of motion. From the new
Poster
Myoskeletal
Alignment - Postural Patterns and Spring Systems
Exercise … gooood!
Incrementally, the more exercise clients are able to do, the
better they will feel. It doesn’t matter what kind of
aerobic exercise — swimming, biking, jogging, walking,
dancing — as long as they hit their target heart rate for at
least 30 minutes a day. Some clients report feeling better
as they gradually increase their exercise programs to 30
minutes twice a day.
Why do clients suffering fibromyalgia improve with
vigorous exercise? One notion suggested is that aerobic
exercise beefs up the body’s supply of endorphins, a natural
pain-dampening and sleep deepening substance. Exercise
increases levels of serotonin an growth hormones, the exact
pain-reducing, muscle- repair hormones that people with
fibromyalgia may lack. Exercise also increases blood flow to
the muscles. It is well-documented that people with
fibromyalgia do have slightly less blood flow to their
muscles, which might also contribute to pain. Exercise and
bodywork together are often just the answer for helping
reverse this often debilitating condition.
Fibromyalgia is a disorder with no widely accepted
medical proof. It is a chronic condition characterized by
symptoms of widespread pain and tender points as well as
fatigue, depression, and sleep disorders. While scientists
at the present time have found no generally accepted way to
medically document the existence of fibromyalgia, it has
been proven that there are physiological changes present in
many who have the disorder. The debate will continue to rage
as to its origin and existence. Some insist that it is a
medical condition while others are convinced that it is a
mental health issue.
Meantime, as the research rolls in and the truth is
eventually decided, it is in the client’s best interest to
immediately begin routinely scheduled bodywork sessions in
conjunction with a specialized exercise regime regardless of
origin. Well structured manual therapy sessions and
individualized rehabilitation programs appear to be the
treatment of choice for this chronic and sometimes disabling
condition that affects an estimated 2 million Americans each
year. |
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