Fibromyalgia

Fibromyalgia is a common and potentially disabling condition that is estimated to affect up to 5% of the population in developed countries, predominantly young to middle-aged women. It is a form of non-articular rheumatism defined by the presence of chronic widespread pain and allodynia (a heightened and painful response to pressure) in more than 11 of 18 specified sites or tender points. Symptoms include widespread pain and tenderness in the body, often accompanied by fatigue, cognitive disturbance and emotional distress. It has been reported to be linked to: traumatic/ stressful events such as a car accident, repetitive injuries, illness and diseases including, but not limited to lupus, rheumatoid arthritis, and ankylosing spondylitis.

Fibromyalgia picture

 

The benefits of exercise for individuals with fibromyalgia are well documented in recent reviews and include reduction of pain and depression and improvement in global health and physical function. Research shows that individuals with fibromyalgia are able to engage in moderate and even vigorous exercise; however, participants have experienced difficulties performing and adhering to vigorous and even moderate-intensity regimes because of increased fibromyalgia symptoms. To gain optimal benefits and ensure long-term adherence therefore, care must be taken to avert exercise-related pain and fatigue and musculoskeletal injury (Busch et al 2011).

 

Obviously the presence and possible causal relationship between fibromyalgia and other co-morbid conditions can impact liability determination in compensable situations.

 

With the above in mind, less demanding and threatening exercise environments such as hydrotherapy can often be a good place to start, as the warmth of the water and relative weightlessness relieves symptoms while the resistance provides a gentle workout. Programs can then be progressed to involve greater land based exercises. Staff of Workplace Physiotherapy have expertise in the management of patients with conditions like fibromyalgia particularly in the presence of co-morbid pathologies.

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Ref: Fitzcharles MA, Ste-Marie PA, Goldenberg DL, et al. 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome: Executive summary. Pain Res Manag 2013;18:119–26. Busch AJ, Barber KA, Overend TJ, Peloso PM, Schachter CL. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 2007;4:CD003786. Busch AJ, Webber SC, Brachaniec M, Bidonde J, VD Bello-Haas, Danyliw AD, Overend TJ, Richards RS, Sawant A, Schachter CL. Exercise Therapy for Fibromyalgia. Curr Pain Headache Rep (2011) 15:358–367.

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The comments above are the implicit advice of Workplace Physiotherapy. The views expressed are based on current evidence-based research and accepted best practice approaches. Unless otherwise stated, these comments are not the view of WorkCover NSW or any other professional body. No reproduction or forwarding of this advice is permitted without the consent of the author.

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