Cognitive Behavioural Therapy for Fibromyalgia


The term "fibromyalgia" is from New Latin fibro-meaning "fibrous tissues", myo-meaning "muscle", and algos-meaning, "pain"; thus, the term literally means "muscle and fibrous connective tissue pain.

Fibromyalgia (FM) being a medical condition characterized by chronic widespread pain and a heightened pain response to pressure requires CBT therapy including usage of other medications and drugs. When someone is suffering from fibromyalgia, they may have more cells that carry pain signals than normal. You can even have more than one cause as listed below:

  1. Genes
  2. Other diseases: A painful disease like arthritis or an infection raises your chances of getting fibromyalgia
  3. Anxiety and depression
  4. Cognitive behavioral therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change destructive or disturbing thought patterns that have a negative influence on behavior and emotions.


Pain processing abnormalities: Fifty percent less stimulus is needed to evoke pain in those with fibromyalgia. Inconsistent reports of decreased serum and CSF values of serotonin have been observed.

Neuroendocrine system Neuroendocrine system: Studies on the neuroendocrine system and HPA axis in fibromyalgia have been inconsistent.

Autonomic nervous system: Autonomic nervous system abnormalities have been observed in fibromyalgia, including decreased vasoconstriction response, increased drop in blood pressure, and worsening of symptoms in response to tilt table test, and decreased heart rate variability.

Immune system: Overlaps have been drawn between chronic fatigue syndrome and fibromyalgia.

Drug therapy:

Most commonly suggested drugs are duloxetine, milnacipran, or pregabalin. Fibromyalgia is estimated to affect 2–8% of the population.

Antidepressants, such as amitriptyline (Elavil) are sometimes prescribed to treat fibromyalgia symptoms.  These medications may affect multiple symptoms – pain, fatigue, depressed mood, and sleep disturbances. Duloxetine (Cymbalta), an antidepressant, is another drug approved by the FDA for the treatment of fibromyalgia.

The anticonvulsant drug pregabalin (Lyrica) has been approved by the FDA for fibromyalgia. Lyrica reduces pain and improves daily function for some people.

Several studies have shown that CBT was effective as part of a program involving exercise, stretching, and education of both patient and family, thus implying CBT as a beneficial treatment.

Benefits of CBT Therapy:

  • Insomnia
  • Emotional distress
  • Cognitive function, especially attention

Physical Therapy:

Physical therapy focuses on the treatment, healing, and prevention of injuries or disabilities. Regular physical therapy programs may help you regain control of your fibromyalgia as you focus on lifestyle changes rather than on the chronic problems of pain, stiffness, and fatigue. According to the American Physical Therapy Association, physical therapists teach self-management skills to people with all types of conditions, including fibromyalgia. Physical therapists can show people with fibromyalgia how to relieve symptoms of pain and stiffness in everyday life. They show them ways to get relief from deep muscle pain. And they can help people with fibromyalgia.

Tools used for physical therapy:

  • deep tissue massage
  • low-impact aerobic conditioning (water aerobics)
  • pain relief exercise
  • stretching and strengthening exercises
  • TENS units (transcutaneous electrical nerve stimulation)

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