Fibromyalgia (FM) is a complex, multidimensional, rheumatological
disorder. It is the third most common rheumatological disorder in the United
States. It affects both men and women; however, a higher prevalence is seen in
women, with 80% of people affected being women between the ages of 20 and 55
years.
FM is characterized by the presence of chronic pain and
tenderness at specific anatomical sites, known
as “tender points”. Other symptoms may include:
·
Sleep disturbance
·
Chronic fatigue
·
Morning stiffness
·
Paresthesia (tingling sensation) in the hands
and feet
·
Enhanced perception of physical exertion
·
Depression
·
Anxiety
As a result of these symptoms, those affected with FM may
also suffer from:
·
Impaired functional ability
·
Low self-esteem
·
Poor physical fitness
·
Social isolation
·
Poor quality of life
The exact cause of FM is as yet unknown; however, the following
factors are believed to increase the risk of developing FM:
·
Muscle abnormalities
·
Neuroendocrine and autonomic system regulation
disorders
·
Genetic predisposition
Due to the multidimensional nature of FM, a
multidisciplinary approach to the management of FM patients has been shown to provide
the best results. This includes appropriate medications to manage symptoms,
client education, cognitive behavioural therapy, hypnosis, acupuncture, and an
appropriate exercise programme.
People with FM will reap the same benefits of exercise that
individuals without FM receive; however, the main goal of a regular exercise
programme for individuals with FM is to restore and maintain functional
ability. The benefits of exercise that are more specific to those with FM
include the following:
·
Reduced number of tender points
·
Reduced pain at the tender points
·
Decreased general pain
·
Improved sleep and therefore less fatigue
·
Improved self-esteem
·
More frequent and meaningful social interactions
·
Improved functional ability
Because of their symptoms, people with FM often become sedentary and, therefore, very deconditioned. They
often complain of morning stiffness, exaggerated delayed-onset muscle soreness,
poor recovery from exercise, and difficulty using their arms when elevated
above their shoulders. High-impact, vigorous activities are also not
well-tolerated. Therefore, low- to moderate-intensity aerobic activity is
recommended for people with FM. One must begin the exercise programme slowly
and progression should be slow and controlled. Supervised exercise therapy
sessions with a biokineticist will ensure appropriate progression and will potentially
increase exercise adherence.
References
ACSM’s Exercise Management for Person’s with Chronic
Diseases and Disabilities
