Exercise remains the primary treatment for fibromyalgia. Many patients have allowed themselves to become deconditioned due to their pain. Exercise should start with the maximum amount tolerated and gradually increase each day. An intense exercise session that leaves you on the couch for several days is of no help. It may be worthwhile dividing your exercise into several brief sessions every day. Walking is the best exercise. Swimming or aquacize can be useful.
Stretching can be done by itself or in conjunction with an exercise program. There are many good books on stretching available. We have a sheet of stretches available at the Pain Clinic. Stretching should be done several times a day for short periods of time. It is a good idea to stretch before your exercise session.
Therapies such as yoga or Tai Chi may be appropriate. The GET SET program offered at the Edmonton General Hospital and the Gerald Zetter Centre is useful in fibromyalgia.
Given that fibromyalgia may be due to a sleep disturbance and that many fibromyalgia sufferers complain of problems sleeping, it makes sense to try to improve your sleep. The Pain Clinic has a handout available on proper sleep hygiene.
A small number of patients with fibromyalgia may suffer from sleep apnea. This is more common in male patients. You may benefit from investigation and treatment of this condition.
You can be taught relaxation and coping skills that you will be able to use on a daily basis. You may benefit from a formal pain management group such as the Life Despite Pain program or other similar programs. There are support groups for patients with fibromyalgia.
Trigger point injections
Trigger point injections are usually not useful in fibromyalgia due to the widespread nature of the pain. If a certain area of your body is more tender, trigger point injections may be useful as part of your therapy.
Despite little experimental evidence that acupuncture is effective in fibromyalgia, many of our patients find it to be effective. Intramuscular stimulation (IMS) which uses acupuncture needles may also be effective.