3 minute read
Fibromyalgia and OT
As we learn more about fibromyalgia, we find new ways to treat it - could occupational therapy be one?
Fibromyalgia is considered to be a medically unexplained syndrome because of its poorly understood nature. This is frustrating for both the patient and caregiver: from the patient’s perspective, people may assume they are inventing the symptoms that they experience, and that they’re all made up, exaggerated, or psychosomatic. From the medical professional’s point of view, it can become a series of trials and errors to find the best way to treat patients, which can become frustrating as you just want to help your patient. Characterised by chronic pain, stiffness and tenderness of the muscles, tendons and joints without the presence of detectable inflammation, fibromyalgia is considered a syndrome with a complex series of factors, each of which can vary in their effect on the client and their daily life. Patients frequently describe what feels like aching or burning pain in their muscles, visual problems, physical and mental fatigue (the latter often called brain fog), and stiffness in the morning. A host of other symptoms can be present, including headaches, IBS, memory problems, parenthesis, hypersensitivity, Raynaud’s phenomenon, and disturbed sleep, to name but a few. Because of this, there is also significant likelihood that clients will present with co-morbitidies, including depression, anxiety, and rheumatoid arthritis. Living with the above symptoms sounds very much like a job for an occupational therapist, and some research has shown that assessment and intervention from an occupational therapist might provide patients with the tools they need to continue completing their ADLs and functioning independently while living with their chronic pain. A study undertaken by Poole et al in 2018 and published in the American Journal of Occupational Therapy focused on a 37-year-old school teacher who was recently diagnosed with fibromyalgia after experiencing pain all over her body while training for a 5k, when she was taken to hospital. It was in this setting that she met an occupational therapist who focused on establishing client-identified problems and goal setting. After evaluating her using the Canadian Occupational
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Performance Measure, the pair identified aspects of Jennifer’s life that were meaningful to her: leisure, being able to complete a full day of teaching (having reduced her hours due to her condition), and being able to clean her entire house. This allowed her occupational therapist to establish a series of goals and structures to help her complete the aforementioned goals. For example, her OT advised her to plan tasks in advance, prioritise cleaning tasks, plan and organise activities, and use good posture and body mechanics throughout these tasks. Jenifer’s OT also recommended online mindfulness classes to help her cope with her chronic pain, identifying this as a significant barrier to her occupational participation; he had her demonstrate a technique to him after each session to ensure she was completing this task. Additionally, her OT established an exercise regime to help increase Jenifer’s endurance and ultimately help her enjoy her leisure time more, as well as complete a full day at work. Her OT also worked with her to identify the emotional impact of living with fibromyalgia, which also impacted her social and leisure activities, helping to implement strategies from her mindfulness course to combat anxiety that comes with feeling overwhelmed. After working with an OT, the study showed that Jennifer identified a significant decrease in the effects of her symptoms on her ability to complete ADLs; while she continued to experience the symptoms of fibromyalgia, she found she was in a better position to deal with them thanks to her experience with an occupational therapist, and felt that the techniques taught to her left her better able to achieve her goals. Of course, this case study - while successful for Jennifer - is simply one case, and as the National Fibromyalgia Association note, while most see a physical therapist, comparably few people living with fibromyalgia see an OT, despite their “unique position to instruct people with fibromyalgia in management techniques that can empower them and be used for a lifetime.” The intervention of an occupational therapist, as part of a multi-disciplinary team, could help people living with fibromyalgia to better cope with their chronic pain through activity planning, goal setting, and mindfulness techniques, all of which are universal to the holistic approach of the occupational therapist.
