Recommendations from others
We were unable to find any guidelines for the treatment of fibromyalgia. Patient information sheets from both the American College of Rheumatology (www.rheumatology.org) and American Academy of Orthopaedic Surgeons (orthoinfo.aaos.org) recommend physical modalities such as heat application, massage, and exercise, including fitness training.
Authors of chapters on fibromyalgia in both Kelly’s Textbook of Rheumatology and Harrison’s Principles of Internal Medicine suggest that patients may benefit from regular low-impact aerobic exercise.12,13
CLINICAL COMMENTARY
Exercise, physical therapy ease pain, “helplessness”
Wail Malaty, MD
Mountain Area Health Education Center, Rural Track Family Practice Residency, Hendersonville, NC, Department of Family Medicine, University of North Carolina, Chapel Hill
Fibromyalgia is a disease of chronic pain. It engenders feelings of helplessness, depression, and loss of control in many patients. In my experience, both physical therapy and exercise can help alleviate these feelings. Physical therapy helps motivated patients perform body movements that they believe may be painful. In this sense, it demonstrates to them the possibility of exercising without excruciating pain. As the evidence suggests, patients who exercise have less pain and feel better in general. Thus, physical therapy can teach patients to actively participate in the management of their disease.