Physiotherapy and Fibromyalgia: a Literature Review

Abstract

The present paper is a review of the literature on fibromyalgia (FM) and a discussion of the consequences this knowledge may have for physiotherapists. FM is characterized by chronic widespread muscle pain, an excessive feeling of fatigue, and poor sleep. The etiology is unknown and the pathogenesis is unclear. Depression and reduced physical capacity have been found that may be the consequences of FM rather than the causes. Patients with FM also report difficulty in performing daily activities at home and work as well as during leisure time. Recent studies have found normal energy metabolism of the muscles and no sign of muscle injuries. Results from several studies suggest that there is a hypersensitivity within the central nervous system, as well as a hyporesponsiveness of the sympathetic nervous system and the hypothalamus-pituitary-adrenal axis. There are no known physiotherapeutic modalities that normalize such dysfunctions. However, it is some support that stimulation of endorphin mechanism by TENS may modify pain in patients with FM. It also appears that it is important to assist patients with FM in adjusting their activities in such a way that they can stay as physically active as possible.