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Physiotherapy for Fibromyalgia

If you deal with the aches and pains of fibromyalgia, the thought of beginning an exercise program may make you cringe. In the long run, however, it can do you a world of good. Consider this: Physical therapy has helped many fibromyalgia patients get active and manage their fibromyalgia pain at the same time.

Anne Reicherter, PT, DPT, PhD, a licensed physical therapist and associate professor in the department of physical therapy in the School of Medicine of the University of Maryland in Baltimore, says physical therapy can help fibromyalgia patients “manage their daily living with less pain and generally make life more enjoyable.” She explains that people with fibromyalgia pain are often caught in a vicious cycle: Pain and fatigue prevent them from being active and exercising, but inactivity can trigger more pain and fatigue.

Another benefit of proper exercise? It’s one way to help you get restful, restorative sleep every night. And good sleep benefits fibromyalgia patients, as sleep disturbances are a common fibromyalgia symptom. Working with a physical therapist can help you get the exercise you need for a good night’s rest. Reicherter says physical therapy can also eventually reduce the need for pain medication, and possibly even surgery.

Fibromyalgia patients may find it hard to start an exercise program on their own because they fear it will make their symptoms worse. By having a physical therapist tailor a gentle, yet effective program with your particular pain and fatigue levels in mind, you can eliminate the hard part — getting started. And a recent study found that fibromyalgia patients who participated in an exercise program designed for their specific needs showed improvements in their mood, functioning, and physical abilities even six months after the program ended.

Physical Therapy Options for Fibromyalgia Relief

Increasing flexibility and strengthening muscles through a maintainable exercise routine are two important ways physical therapists reduce fibromyalgia pain and make life more manageable. Options include:

Aerobic exercise

Low-speed and low-impact activities are best, says Reicherter. Stationary bicycles and elliptical machines are usually less stressful on the joints.

Aqua therapy

Swimming and other water exercises are excellent for fibromyalgia patients. Says Reicherter, “The buoyancy of the water can lessen stress on muscles and joints and improve flexibility.” A heated pool may be especially beneficial because the heat can soothe sore muscles.


By increasing flexibility through stretching, tight, stiff muscles loosen up, providing fibromyalgia relief. Your physical therapist can instruct you on the proper way to stretch muscles, tendons, and ligaments. The National Pain Foundation recommends keeping the number of repetitions low — 5 to 10. Holding a stretch for 30 to 60 seconds is good for large muscle groups, with possibly only one to two reps necessary.

More Ways to Relieve Fibromyalgia Pain

Transcutaneous electrical nerve stimulation (TENS) stimulates nerve fibers and can decrease fibromyalgia pain. Reicherter says TENS helps:

  • Block pain signals to the spinal cord
  • Release the body’s own natural pain-killing chemicals
  • Improve local circulation and gently contract muscles for healing and relaxation

Dry needling: Treatment of fibromyalgia using dry needling targets muscles with trigger points and helps to relax muscles that are causing the pain. Research suggests dry needling has an affect on the pain signals that come from the brain.

Manual therapy :

Trigger point release and manipulation of spine has also been considered beneficial

Some fibromyalgia patients say they feel worse after starting therapy, but Reicherter says this should not happen if you are getting good therapy and are going slowly. Overdoing exercise or activities after you start to feel better can make you feel worse. Reicherter also points out that exercise soreness is different from fibromyalgia pain. Once you get used to the exercise, you should start reaping its benefits: less pain every day.