Chronic widespread pain and fibromyalgia syndrome (FMS) are disorders of pain regulation with central sensitization. Several tender trigger points define FMS, but recently, a composite of the following has been used to identify the syndrome:
- Pain for >3 months affecting four of five specified body areas, and;
- A raised widespread pain index and symptom severity scale score for fatigue, waking unrefreshed and cognitive symptoms.
Other symptoms commonly reported include depression, anxiety, headaches, migraines, diffuse abdominal pain with changes of bowel habit (irritable bowel syndrome) and urinary frequency. The pathogenesis of these syndromes is not clear, but hyperexcitability of the central and peripheral nervous systems, changes in function of pain receptors, altered pain perception and somatization have been hypothesized. There is functional magnetic resonance imaging evidence of altered pain and increased activity in brain areas that code for the sensory intensity of various stimuli. These conditions impair quality of life but are not life-threatening.
In clinical practice, CWP is defined as ‘pain lasting >3 months that affects both sides of the body both above and below the waist, including some part of the axial skeleton’. Many patients with CWP report sleep disturbance and chronic fatigue.
Active Health Clinic first started managing pain when we noticed many of our clients experienced chronic pain with their fatigue. Our clients with chronic pain responded well to our graded movement program. Over time, and with further research and professional development on pain conditions, we developed more interest in treating these people who once were in the 'too hard basket'. Their exceptional responses to our treatment were exciting and encouraged our development of our pain program. Cutting edge research into central sensitisation and the treatment of pain, as well as our own personal experience with pain, led us to believe that pain can be treated, not just managed, with appropriate care and time. Seeing our clients' success grows our passion for helping you win the fight against pain, too.
Our rehabilitation program consists of 10-15 individual, personalized sessions over 6-18 months. The sessions are aimed at helping you develop tools to treat your pain and help you manage it on your own, saving you money and time that might otherwise be spent on unnecessary treatment.
The program covers:
- Understanding the neurophysiology of your condition
- Identifying the demands of your activity and your capacity (using a variety of tools eg. heart rate monitors, heart rate variability and activity diaries)
- Pacing strategies (physically, mentally, socially, environmentally, emotionally)
- Movement guidelines/ exercise advice
- Pain management
- Trigger identification and modification
- What to do when you have a setback
- Goal setting
- Gradual exposure strategies
- Causes of sleep disturbances and techniques to help with sleep
- Parasympathetic activity / Relaxation techniques
- Mindfulness exercises and how to live more mindfully
- How to identify your body’s stress response
- Stress, anxiety and mood management strategies
- DIM/SIMS – Threats and safety to the mind/body
- Symptom Mapping
- Return to work planning
- Ergonomics for pain
- Return to school planning
- For women: Understanding your menstrual cycle, its impact on your symptoms and how to support this
- Strength training to improve physical capacity, without exacerbation of symptoms (if applicable)
Our program aims to help you have a ‘normal day’ or return to work or school and life.
Through pacing activity and graded increases in exercise or activity, we are able to build your capacity, without increasing your symptoms. We know this journey is a bit rocky so we give you the skills to deal with any future problems, through setback planning and providing you with a therapy manual you can turn to in times of need.
See our Testimonials page to hear from those who have experienced our program for themselves.
Living with chronic and widespread pain can impact your ability to shop, prepare, cook and eat the food that you need to maintain adequate nutrition. Many people with Chronic Pain Syndrome or Fibromyalgia also experience abdominal pain and other gastrointestinal symptoms that can make enjoying food difficult. Research suggests a link between chronic pain and IBS.
Our dietitians understand the connection between pain sensitisation and the gut. They work with you to understand your symptoms and implement individualised strategies to help reduce these symptoms and increase the variety of foods you can enjoy.
Some topics that may be covered to support you and your body when living with chronic pain include:
- Making food more accessible and less energy demanding
- Strategies to assist with the management of gastrointestinal symptoms and visceral hypersensitivity whilst maintaining as wide a dietary as possible. Using both food and non food based approaches such as the low fodmap diet and guidance towards gut directed hypnotherapy.
- Eating patterns to improve your energy levels and support your overall wellbeing
For program costs and rebates available, please call the clinic.
Do I need a referral? What if I can't get to your clinic?
A referral isn't always necessary however may impact on your ability to get a rebate - speak to our friendly reception staff and they can help you. Our clinics are located in Blackburn & Mornington, Victoria, however, all services are offered via telehealth also.
Can I exercise if I’m already in pain?
Yes, "motion is lotion". Exercise can be a confronting idea when you already have significant pain, however, exercise is one of the key rehabilitation tools for fibromyalgia and chronic pain. It is essential to move/exercise with care and under the supervision of an experienced practitioner who can guide you, allowing you to move without experiencing more pain. It is normal to experience some discomfort whilst moving and exercising. We will work out the exercise type and load most appropriate for you based on your current symptoms, ability to move and overall history. For some people, exercise may include functional activities, such as showering, cooking or light chores. You will be able to increase your exercise and activity gradually, giving your body enough time to adapt and manage any symptom triggers.
Physical activity is very important for people with fibromyalgia or chronic pain, to manage and reduce pain, to avoid deconditioning, and to reduce the risk of general health problems, such as diabetes or cardiovascular disease. In our program, we will focus on your specific health and pain limitations to make sure exercise does not lead to you feeling worse , but helps you move and function better, and improves your overall health and wellbeing.
Our graded activity program provides you with a holistic approach that encompasses your daily needs and activities. This means we will work out an appropriate movement/exercise baseline and progressions, and also teach you about exercise types and postures, your environment, the pacing of day-to-day activities, sleep, nutrition, and stress and anxiety management. Exercise may be one of the most beneficial tools to help you recover, but it can't reach its maximum potential without these accompanying therapy tools.
Time to get on top of your pain?