According to a recent lecture I attended at the Combined Sections meeting of the American Physical Therapy Association, Fibromyalgia (FMS) continues to rise in prevalence. A 1997 report stated that FMS is the second most common musculoskeletal problem for which people visit rheumatologists. It has been estimated that 3.4% of women and 0.05% of men have symptoms of FMS.20% of people visiting rheumatologists receive the diagnosis of FMS. Since the most prevalent symptom reported by those who are diagnosed with FMS is multiple point or full body musculoskeletal pain, individuals with FMS are being referred to physical therapy for treatment, management and prevention of pain and dysfunction.
It has been found that those diagnosed with FMS suffer from the following symptoms:
1. Pain all over
2. Stiffness of joints
3. Swelling of joints and tissues
4. Overwhelming fatigue
5. Tender points
6. Muscle spasms or nodules
7. Impaired memory or concentration
8. Irritable bowel syndrome
9. Headaches
10. Interstitial cysts
Recent studies have linked non-restorative, unrefreshing sleep patterns to FMS. Also, certain hormones that are released in the body have been found to be ill reactive in people with FMS.Growth hormone (measured by levels of insulin-like growth factor 1 or IGF-1) is decreased in FMS due to the sleep disturbances.80% of the 24-hour production of growth hormone is secreted during stages 3 and 4 of sleep. People with FMS do not reach stage 3 and 4 of sleep 60% of the time. Cortisol, known as the stress hormone, also fluctuates in individuals with FMS. Cortisol works in conjunction with glucose in the body. As glucose decreases, cortisol is to increase. In cases of FMS, cortisol levels are not increasing and therefore, are not maintaining the balance needed with glucose to fight stress within the body.
How then, can physical therapy help?
As a physical therapist treating clients with FMS, I recommend that in conjunction with the physician, the above mentioned hormone levels be evaluated. If these are to be found deficient, then measures can be taken to regulate these hormones either medicinally or naturally. As far as the symptoms of pain, stiffness, swelling, tender points, fatigue, muscle spasm, and headaches, there are numerous physical therapy interventions to help first reduce the symptoms and then to gain strength, endurance and a general feeling of well being.
It is important for those suffering from FMS to seek a practitioner who has some understanding of the underlying causes of this syndrome and who also is sensitive to the exacerbations of symptoms and knows how to help regulate these occurrences.
If you suffer from FMS or have the above symptoms but have not been diagnosed, contact Balance For Wellness for a physical therapy evaluation and begin your road to recovery.
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