What is the Fibromyalgia Day Program
The Fibromyalgia Program at St. Joseph's Health Care London is a multi-disciplinary treatment program for people with Fibromyalgia. The focus of the program is not medical. Instead we teach people to learn to cope with their symptoms and improve their quality of life. Although many patients achieve a reduction in their symptoms, at present there is no known cure. Thus the goal of the program is to reduce the degree of suffering and life disruption associated with this disorder. Participants in the program must be ready to learn self-management techniques in order to:

• Increase their ability to participate in work, household and social activities without increasing pain.
• Modify their emotional reaction to pain and its consequences on self-esteem, marital relations, family life, ability to work and social involvement
• Achieve greater control over their symptoms

• Have a diagnosis of Fibromyalgia by a Rheumatologist
• Be available for a full-time four week interval
• Accept a treatment approach that is geared toward improved function and coping rather than short-term pain relief
• Be willing to eliminate the use of certain pain medications (e.g., those containing codeine) and tranquillizers (e.g., diazepam)
• Be willing to eliminate short-term pain relief methods (e.g., heating pads, massage, TENs, etc.)
• It is important that spouses or significant others and children (older than 13 years) be willing to attend one 90 minute session per week during the month a participant is in the program. These sessions are designed to teach family members how they can better help the person with Fibromyalgia.

• Psychology
• Physiotherapy / Kinesiology
• Occupational Therapy
• Social Work

1. You must be able to tolerate being active for a full 7½ - 8 hour day. Each day the program starts at 8:30 or 9:00 a.m. and continues until 4:00 p.m. Although some breaks occur through the day, most of the day is taken up by specific activities (e.g., physiotherapy, occupational therapy, group education/ therapy sessions, individual appointments, independent reading, etc.). In addition, some "homework" done most evenings.
2. Physiotherapy sessions are 1 - 1½ hours and occur daily. This time includes cardiovascular exercises, muscle strengthening exercises and stretching exercises. Although these start out at a low level, they are gradually increased as the program progresses. For example, you must be able to start at about 5 minutes on a treadmill (walking) and be willing to increase that to about 20 minutes by the end of the program. Similar goals are set for the stretching and strengthening exercises.
3. There is a graded activity component in occupational therapy sessions. These sessions are also held daily for one hour. During this time, you will be required to increase your tolerance for various activities using proper body mechanics for sitting and/or standing.
4. Pain management group sessions are educational presentations which teach various psychological coping techniques (assertiveness, attitude change, reducing pain "body language," etc.). These sessions require that you can sit for a period of 1½ hours. Although there is a 5 minute break in the middle and you can stand up and stretch when you need to, you must be able to sit for fairly long intervals.
5. Although participants are encouraged to "pace" their activities - interspersing rest and activities and changing from one activity to another - there is no opportunity to nap during the day. This will be a problem if you feel that you must nap during the day and cannot manage without it.
6. The program also requires that you are willing/able to concentrate for fairly long periods of time (e.g., during educational sessions). Although we don't expect participants to remember every detail, it is important that you can listen and understand the material being presented.

• Education about Fibromyalgia
• Changing how you express pain and illness
• Communication Skills (Assertiveness)
• Cognitive Therapy (changing the way you think and feel about yourself, your situation and your future)
• Daily Exercise Program (cardiovascular, stretching, strengthening)
• Graded Activity Program (increasing your tolerance for activities while controlling pain and fatigue)
• Relaxation Training
• Education about proper posture and body mechanics