A vital part of treating patients with fibromyalgia is patient education, functional rehabilitation  and cognitive behavioral therapy. The passive treatment provided by laser acupuncture will only provide temporary relief unless the patient is able to change the way they think about the mechanical  factors that have been contributing to their pain and be encouraged to change them. Some patients may not be ready to participate in the rehabilitative process ( precontemplative ) and others are not prepared to put any effort into the healing process hoping for some instant magical cure. Unfortunately, as deconditioning of the neuromuscular system is part of the illness, we need to be able to convince the patient to strengthen their muscles without exacerbating  their pain. This process can be divided into 9 parts:

1     breathing technique

2    avoiding hip rib impingement

3     avoiding groin impingements

4    avoiding chest wall compression

5    avoiding shoulder impingements

6     avoiding neck impingements

7     safe stretches

8     pacing

9     safe strengthening exercises

The breathing technique I recommend is similar to the  reverse abdominal breathing technique often taught at Yoga or Qi Gong. In reverse abdominal breathing, the abdominal and pelvic floor muscles should contract with inspiration. Studies have shown that the diaphragm, intercostal muscles , the lateral abdominal muscles and pelvic floor muscles all co-contract . This means that when one of these groups of muscles contract, all the others also partially contract automatically. When this occurs the spine is braced or stabilised. This was what the system was designed to do. The co-contraction also increases intra-abdominal pressure thereby increasing venous return to the heart. This reduces the risk of fainting compared to the commonly taught abdominal breathing.

The main modifications to reverse abdominal breathing are that the patients should breath in and out only through the nose and to hold their breath as long as comfortable in inspiration. They should breathe out as little air as possible on expiration and breath in as deep as possible during inspiration. In this way more CO2 is retained and this increases O2 availability to the tissues (similar to Buteyko Breathing Technique ). I call this technique Posture Breathing as it corrects spinal posture, prevents hip rib impingement, chest wall compression and has the benefits of both reverse abdominal breathing and Buteyko breathing.  I will describe the Air Bag Technique in the next Blog at www.drchrischinbackpain.com