Fibromyalgia can be understood as a painful clinical syndrome of origin and cause still inconclusive. In view of the variety of symptoms presented, its diagnosis is difficult, and it can be confused with several other diseases when they present with diffuse pain and fatigue.
In addition to diffuse pain in skeletal musculature and the physical finding of multiple tender points, most patients with fibromyalgia also report fatigue, muscle stiffness, pain after physical exertion and changes in sleep.
There may also be symptoms of depression, anxiety, memory impairment, inattention, tension headache or migraine, dizziness, vertigo, paresthesia (tingling), among several other symptoms not related to the locomotor system.
Pain is the main symptom of fibromyalgia, sometimes the level of pain is so intense that it interferes with work, activities of daily living and the quality of life of patients and its control is one of the main goals of treatment.
Fibromyalgia is a rheumatic syndrome of unknown etiology, which predominantly affects women, characterized by diffuse and chronic musculoskeletal pain, in addition to specific anatomical places painful to palpation, called “tender points”. Other symptoms are often associated, such as fatigue, sleep disorders, morning stiffness and psychological disorders, such as anxiety and depression. Sometimes the level of pain is so intense that it interferes with work, activities of daily living and the quality of life of patients.
The large number of patients who come to the Rheumatology, Orthopedics and Physiotherapy Clinic with complaints compatible with the diagnosis of fibromyalgia justifies the great interest that this syndrome has aroused. Finding effective treatment alternatives that minimize the impact of fibromyalgia on patients’ quality of life is fundamental for the health system.
Pilates treatment for Fibromyalgia patients
Some studies have shown that fibromyalgia patients had higher levels of fatigue, exertion and induced pain after exercise compared to healthy individuals and a higher level of perceived exertion during and after exercise. One of the main issues within this context that remains unclear refers to the type, intensity and duration of physical exercises most suitable for the treatment of patients with fibromyalgia.
In general, it can be noted that low-intensity exercises such as Pilates are the most effective, producing a decrease in the impact of fibromyalgia on the quality of life of patients.
An important feature of Fibromyalgia is sleep disorders that are present in more than 90% of patients. On the rare occasions when they have a restorative night’s sleep, some report improvement in symptoms of pain and fatigue the next day. In addition, the number of tender points is related to non-restorative sleep.
Pilates works the body as a whole, but it also exercises the mind because through body awareness, mindfulness is awakened to the present moment during exercises, promoting both physical and mental relaxation after activity, thus significantly improving the sleep quality of those who practice it.
The improvement seen in patients who practice Pilates probably occurs due to the relationship between physical exercise, which is considered as one of the best non-pharmacological interventions to improve sleep quality. Several studies show the effect of exercise on sleep, and the results show that sedentary individuals have a worse quality of sleep than individuals who exercise regularly.
In a European study carried out in 2016 it was found that the most important result of treatment with Pilates in patients with fibromyalgia is that the Pilates method has been shown to be effective in reducing pain and improving sleep after 15 sessions.
Most of the time, patients have low cardiorespiratory fitness and reduced muscle strength. As a consequence, a vicious cycle begins, in which pain, as a result of physical effort, makes these people avoid any exercise, an attitude that ends up perpetuating the symptoms. Physical inactivity leads patients with Fibromyalgia to a decline in neuromuscular function, muscle endurance, muscle contraction speed and cardiorespiratory function. This interferes with functional performance, which includes walking, climbing stairs and other daily activities.
A study carried out in 2010 at USP to compare the effectiveness of stretching and strengthening exercises in improving pain, symptoms and quality of life in patients with fibromyalgia compared to the control group concluded that both stretching and strengthening had significant gains after treatment and in several fibromyalgia symptoms as well as quality of life aspects. The comparison between the groups showed that exercises like Pilates are efficient for improving functional capacity, morning tiredness, stiffness and vitality.
Physical exercise programs promote the greatest gains in reducing the impact of fibromyalgia symptoms on patients’ lives. The type, intensity and duration of these programs are varied, making comparison difficult. Low-intensity exercises, or those in which the patient is able to identify the limit of his effort and pain, seem to be the most effective. Thus, Pilates would be a great alternative for these patients because the exercises have no impact and the body’s own strength is used in its execution.
Stretching exercises through Pilates, in turn, allow the recovery of functional muscle length, allowing tension relief, posture realignment and improvement in range, in addition to freedom and awareness of movement.
Benefits of Pilates in fibromyalgia patients
Pain relief
Gain stretching and muscle strength
Improvement of motor capacity in activities of daily living
Improved sleep quality
Gain balance and motor coordination
Improved body awareness
Improved posture and range of motion
Muscle endurance gain
Improved quality of life
Conclusion
Fibromyalgia has been recognized as one of many chronic pain syndromes originating in the central nervous system (CNS) that are common in the general population. There is evidence of a genetic predisposition for its development that, associated with exposure to environmental factors (stressors), initiates the manifestation of symptoms.
Among the forms of resistance training, the Pilates method emerges as a form of physical conditioning particularly interested in providing general well-being to the individual, thus being able to provide strength, flexibility, good posture, control, awareness and perception of movement.
Scientific evidence reveals that exercises through Pilates can minimize pain, fatigue and muscle tension, improving levels of stress, anxiety, depression and sleep quality in individuals with fibromyalgia, when performed regularly and monitored. Thus, it is very important to carry out a prior assessment of this group with pathology and, from there, define the best way to be worked through the Pilates method, always taking into account the places that patients refer pain during exercise and the physical limitations of each caused by the disease.
Without a doubt Pilates becomes increasingly one of the best activities