Fibromyalgia Jonathan Cooke Kevin Repay Tara Ruberto

What is Fibromyalgia? Fibromyalgia (FM) is a chronic pain illness characterized by widespread musculoskeletal aches, pain, and stiffness, soft tissue tenderness, general fatigue, and sleep disturbances. - (National Fibromyalgia Association, 2006)

Common Sites of Pain The most common sites of pain include the neck, back, shoulders, pelvic girdle, and hands, but any body part can be affected.

Signs and Symptoms Pain Fatigue Sleep disorder Chronic headaches Temporomandibular Joint Dysfunction Syndrome Irritable Bowel Syndrome

Contraindicators for Physical Activity Cold/humid weather Insufficient sleep Fatigue Excessive vigorous physical activity or inactivity Anxiety Stress Strenuous strength training exercises

Treatment/Suggestions Moderate intensity aerobic exercise –Swimming or walking Lifestyle adaptations –Nutritional changes –Improves sleep regimen Medications –NSAIDS (Ibuprofen) –Acetaminophen Therapies –Therapeutic massage, application of heat or cold, acupuncture

Tips for Exercise Moderate intensity aerobic exercise Perform functional strength training exercises using light weights Focus on flexibility however, avoid overstretching Include pauses between exercise repetitions Segment strength training – Perform exercises for upper extremity and lower extremity muscles groups on separate occasions

Tips for Exercise Cont … Limit strenuous strength training activities Limit vigorous physical activity Avoid eccentric muscle contraction Incorporate at least 1 say rest between sessions –Essential to find a midpoint between too much and too little activity

Recommendations for Exercise Programming The goal of exercise programming should be first and foremost to prevent further de-conditioning that could compound the disability. Clients should be warned that they may feel increased fatigue in the first few weeks of an exercise program Exercise should be initiated at very low levels based on clients current activity tolerance Aerobic exercise should use familiar activities at low levels of intensity The focus should be to get client physically functional ie. push, pull, walking up stairs Flexibility exercise may be prescribed to preserve normal range of motion

Recommendations for Exercise Programming Con ’ t Strength training exercises should be based on preservation of levels of strength Progression of exercise activity should focus primarily on increasing the duration of moderate intensity activities instead of increasing exercise intensity Emphasize use of motivational cues – social and extrinsic Avoid eccentric or upper extremity overhead loading Supervise and control with follow up support Avoid early morning exercise Ensure adequate time and attention for client

Special Considerations Depression may accompany condition as lifestyle changes occur due to persistent symptoms Often clients will express frustration as people are not sympathetic to their condition Clients tend to cope with symptoms by planning acivities to budget their energy

References Mondell, D. L. (c2005.). Living with fibromyalgia 4 steps to manage pain and lead a fulfilling life / (1st ed. ed.). New York : McGraw-Hill,. National Fibromyalgia Association. (2006). Retreived February 1, 2007, from Sietsema, K. E. (1997). Chronic Fatigue Syndrome. In J.L. Durstine & G.E. Moore (Eds.), American College of Sports Medicine: Exercise Management for Persons with Chronic Diseases and Disabilities. (pp ). Windsor: Human Kinetics Wallace, Daniel J. (Daniel Jeffrey), (2002.). All about fibromyalgia. Oxford ; New York : Oxford University Press,.