Physio for fibromyalgia: gentle exercise and pacing that helps

What is fibromyalgia?

Fibromyalgia is a long-term condition that causes pain in many parts of the body, together with fatigue, sleep problems and sometimes trouble concentrating. It is thought to involve a nervous system that is more sensitive to pain signals. It is diagnosed by a doctor, based on your symptoms, an examination and tests to rule out other causes.

Common signs

• Aching or burning pain that is felt on both sides of the body and above and below the waist
• Feeling tired even after a full night in bed
• Stiffness, especially in the morning
• Trouble concentrating or remembering, sometimes called fibro fog
• Headaches, tingling or increased sensitivity to touch, noise or light
• Symptoms that go up and down, with flare-ups after stress, illness or overdoing it

How a physio can help

A physio does not diagnose fibromyalgia, but can be an important part of your care once your doctor has. They will look at how you move, what you can currently manage and what has become hard. Treatment usually focuses on:

• Explaining pain and flare-ups so symptoms feel less alarming
• Gentle, graded exercise such as walking, water-based exercise or low-load strength work, started low and built up slowly
• Pacing, so you spread activity across the day and week instead of crashing after a good day
• Stretching and relaxation or breathing strategies if they feel good for you
• Practical tips for work, housework, sleep and getting back to the things you enjoy
• A plan for flare-ups, so you know what to do and how to ease back in

See our guide to physio for chronic pain for the wider picture on persistent pain.

Exercise and flare-ups

Exercise is one of the better-supported ways to manage fibromyalgia, but starting too hard can bring on a flare. A good plan begins at a level that feels easy, increases in small steps, and expects some ups and downs. If a flare happens, most people do best by reducing the load for a few days rather than stopping completely, then building back up.

Things you can try at home

• Aim for short, gentle activity every day, such as a 5 to 10 minute walk, and build up slowly
• Pace jobs through the day, and take a rest before you are worn out
• Keep a regular bedtime and wake time
• Try warm showers, heat packs or gentle stretching if they ease the stiffness
• Talk to your doctor about sleep, mood and medicines, and do not change medicines without advice

When to see a doctor first

See your doctor if you have widespread pain and tiredness that has not been assessed, or if your symptoms change. Get medical advice promptly for new weakness, numbness, fever, unexplained weight loss, red, hot or swollen joints, or pain that is severe and sudden. For urgent symptoms such as chest pain or trouble breathing, call 000.

Costs and funding

Fees vary by clinic. Fibromyalgia is a long-term condition, so your doctor may be able to set up a chronic disease management plan, which can help with the cost of some physio visits. See our chronic pain management plan guide, physio cost guide and Medicare guide for the detail.

Common questions

This guide is general information, not medical advice. Talk to your doctor or physio about your own situation.