The aches and pains of Fibromyalgia

Hello everyone

I am currently on my Musculoskeletal outpatients placement. I must admit it has been a challenge so far, however I am thoroughly enjoying the opportunity to develop and apply the skills we have acquired at university.

I am currently treating a patient with the debilitating condition of fibromyalgia. This condition proves extremely difficulty and demanding to all aspects of the physiotherapy assessment and treatment session. I thus thought it would be very useful to offer you some suggestions which I have found useful when dealing with not only this condition but also the anxious, depressed and stressed patient often associated with fibromyaligia.

Fibromyalgia is a complex condition where a patient will present with long-standing pain which can encompass the entire body. The patient may also experience tender points in joints, tendons and muscles. The aches and pains of my patient involved her arms and legs, but in particular through her mid-thoracic and chest regions. These aches and pains are constant, she is painful and stiff first thing when she wakes up, they progressively become intolerable as the day progresses so by the time bed comes round she is totally exhausted but because she is still in pain she can’t sleep! As you can appreciate this condition has dramatically decreased her social activities, employment and ultimately her quality of life. In addition to the aches and pains, she feels constantly fatigued, she has difficulty sleeping, irritable bowel syndrome and huge amounts of anxiety and depression.

Dealing with this type of patient can be very frustrating and overwhelming. Every part of the body I assessed was painful! What and where are the main sources of pain? Is that the same pain? Is it a different pain? These are just a couple of questions I had to continually ask throughout the long treatment session. It is not easy to comprehend the pain and suffering that these patients are going through. The level of pain they are experiencing is overwhelming and relentlessly affects their quality of life.

The first approach I found to help deal with her pain is to show compassion and empathy. To understand the disorder and to understand the symptoms that the patient is experiencing educate yourself, the internet has a huge amount of information. Once your educated you can educate your patient. There are also many organisations that specialise in Fibromyalgia and other related diseases such as the National Fibromyalgia Association. Pass these details onto your patient so they can learn more about the disorder and speak to other people who are dealing with similar problems. Suggest activities such as hydrotherapy and stretching that aren’t too tiring but provide warmth, circulationg and promote a general feeling of well-being.

The emotional side of this disorder is probably more challenging than the pain. My patient was pessimistic and depressed. Its important for you therefore to remain optimistic, provide many words of encouragement and suggest lifestyle changes that may be promoting additional stress in their already challenging life.

I hope this helps with your clinical situations. Enjoy the rest of your pracs and if anyone has any more info that may help this type of patient feel free to make a comment.

Heidi.