It is important to recognize that Fibromyalgia is a heterogeneous condition comprising a range of symptoms and features, effective management must take all of these factors into account.
The successful management of Fibromyalgia can be carried out utilizing a three-phased treatment approach. Any treatment used in isolation is most often doomed to fail. The initial phase should involve identification of any underlying causative factors and addressing those first (i.e., sleep, diet, connective tissue diseases, thyroid disorders, DHEA deficiency). This phase would include implementation of appropriate medication as needed to address the underlying causative factors. Another important aspect of phase one treatment is education about Fibromyalgia and the causative factors. Once the particular areas of concern have been controlled or improved phase two can begin. This phase attempts to diminish the painful tender points through the use of myofascial release, massage, physical therapy and when necessary, trigger point injections. The final phase attempts to improve the diminished endurance state through the use of aerobic exercise. However, if exercise is implemented too early as an intervention, before correcting those factors necessary to ensure muscle has an adequate opportunity to repair, then further deterioration may ensue.