National Pain Week – Fibromyalgia


Fibromyalgia is a complex condition which unfortunately affects 3-5% of Australians. This is about 1 million people in any given year. The symptoms vary between individuals but most commonly include widespread pain and tenderness, poor sleep and excessive fatigue, and may involve some brain function processes.


Although there is still research to be done most studies have shown abnormal pain processing within the nervous system. The processing of pain within the nervous system has connections with stress regulation, immune, emotion, memory and sleep systems within our bodies. This is why fibromyalgia is often associated with the above systems and can involve depression, excessive fatigue and sleep disturbances. Your experience with fibromyalgia is unique and as such requires an individualised treatment plan

An individualised treatment will usually require a plan with a variety of components

Manual Therapy or ‘hands on’ treatment techniques can be helpful to reduce pain and support the active (exercise ) component of the program.

Medications – There are a number of medications that have been shown to be of some benefit in managing FM. The risks and potential benefits need to be considered carefully and best done in consultation with a medical practitioner.

Hydrotherapy has been shown in studies to reduce pain and improve function.

Aerobic Exercise performed at the appropriate dose can improve functional tolerance of everyday tasks that are currently difficult.

Strengthening Exercise – Activities that you feel weakness prevents you from doing easily can be targeted with strengthening. With the correct dosage your strength and your abilities to do those tasks can improve.

Clinical Psychology – A Clinical Psychologist may assist in the management of FM in a variety of ways. Thoughts, emotions and behaviours are interlinked with, and can impact, your physical wellbeing. You will be provided with tools that can assist in the areas of stress management, emotional regulation, habit change, interpersonal relationships and depression.

Breathing Exercises – Mindful relaxed breathing . The breath is integral to downregulating the stress response in the body. Slowing, lengthening and deepening your breathing can bring calm and regulate energy. I recommend the app ‘Smiling Mind’, it is a free download for iPhone and android. It provides simple guided meditations often utilising breathing and usually around 10mins. I would suggest using ‘smiling mind’ for a session in the evening prior to bed

Acupuncture – Can be of benefit in pain reduction.

Mindful Movement – Includes Tai Chi, Yoga and Qigong.

Sleep – Quality and quantity is essential to restore the mind and body and manage FM. Resources can be found on the website of the Sleep Health Foundation.

Assessment – The revised fibromyalgia impact questionnaire (FIQR) is used to measure the effectiveness of the management plan.

Brendan Clark at Physio Connex can assist with management of this challenging condition, liaising with others in your team, including your GP.




  1. EULAR Revised recommendations for the management of fibromyalgia – Annals of the Rheumatic Diseases 2017 Feb; 76(2): 318-328
  1. 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome – Canadian Pain Society, Canadian Rheumatology Association
  1. Flexibility exercise training for adults with fibromyalgia – Cochrane Database of Systemic Reviews 2019; Issue 9
  1. Mixed exercise training for adults with fibromyalgia – Cochrane Database of Systematic Reviews 2019; Issue 5
  1. Aerobic exercise training for adults with fibromyalgia – Cochrane Database of Systematic Reviews 2017; Issue 6
  1. Mind and body therapy for fibromyalgia – Cochrane Database of Systematic Reviews 2015; Issue 4
  1. Pool-based exercise for amelioration of pain in adults with fibromyalgia syndrome: a systematic review and meta-analysis – Modern Rheumatology 2020 Sept 29
  1. Acupuncture therapy for fibromyalgia: a systematic review and meta-analysis of randomised controlled trials – Journal of Pain Research 2019 Jan 30;12;527-542
  1. Effectiveness of exercise on fatigue and sleep quality in fibromyalgia: a systematic review and meta-analysis of randomised trials – Archives of Physical Medicine and rehabilitation 2021 April; 102(4):752-761
  1. Effectiveness of Tai Chi on fibromyalgia patients: a meta-analysis of randomised controlled trials – Complementary Therapies in Medicine 2019 Oct; 46:1-8