Treat Fibromyalgia Pain With Physical Therapy


Fibromyalgia is poorly understood, difficult to diagnose, and frustrating to treat. The disease affects almost five million Americans, with nearly 90 percent of them women. A diagnosis of fibromyalgia tends to occur in the 30-50 age range, though sufferers may have had symptoms many years prior and not affixed a particular name to it. Major symptoms of this malady are widespread pain and chronic fatigue. While there are some drugs that address common symptoms, no cure exists yet. What you may not know is that there are treatments, such as physical therapy, that can help you manage pain, increase your energy level, and improve quality of life.

Why Physical Therapy?

The debilitating part of fibromyalgia is that it encourages those afflicted to be less active in day-to-day life. This results in poorer physical health, which makes you feel worse. It’s a vicious cycle. It’s easy to see why a person in pain might instinctively fear physical therapy, believing the movement will only increase the hurt.

The thing to keep in mind is that your physical therapist will be a trained professional. He or she will help develop a customized exercise program that teaches you how to interpret pain, when to back off, and when to keep moving. Do you still wonder if it can actually help? There are numerous studies that show education combined with aerobic and strengthening exercises are the surest path to improvement.

Get Educated

It stands to reason that the more you know and understand your condition, the better overall health you can achieve. That’s where your physical therapist comes in. They won’t just give you a set of exercises and send you out into the world to implement them. A physical therapist has a background in anatomy and kinesiology (study of movement) and can help you understand how fibromyalgia affects the body and why you feel certain kinds of pain. It’s important to feel like you control the pain, rather than vice versa.


When it comes to exercising, don’t imagine a puffed-up bodybuilder repping maximum weight on the bench press, heaving like a steam engine and grunting like a bear. When it comes to improving fibromyalgia, the key is to undertake a moderate exercise program. Some possibilities your trainer might suggest are aerobics, aquatic exercises, stretching, strengthening, yoga, tai chi, deep breathing, and massage.

A therapist will work to combine some or all of these activities into a program that targets you individually. Key guidelines to remember are start slow, keep a modest pace, set realistic goals and, perhaps most importantly, don’t hesitate to modify the program during times of severe stress and pain.

A Broad Approach

Fibromyalgia is a tough nut to crack. Many physical therapists recognize that going beyond traditional exercise routines is beneficial. They might suggest certain “mind-body” techniques. Common examples would be biofeedback, cognitive behavioral feedback, or meditation. The key concept to keep in mind is that you may receive suggestions that lie outside your comfort zone. Don’t be afraid to try them.
The bottom line to remember in treating fibromyalgia is that this is not a disease well-suited to taking a daily pill and being done with it. Your treatment will likely pull from many different disciplines. Don’t write them off as “silly” until you give them a chance. Something as simple as learning how to establish more restorative sleep patterns could make a huge difference in how you feel from day to day. Here’s a hint: daytime sleeping tends to throw things out of whack. Try skipping the mid-afternoon nap. It’s better to have a set time to go to bed and get up.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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