What is Fibromyalgia?
Fibromyalgia is a chronic pain disorder that affects how the nervous system processes and responds to pain. It is characterised by widespread musculoskeletal pain, often accompanied by fatigue, poor sleep, “brain fog”, and increased sensitivity to physical or emotional stress.
A key feature of fibromyalgia is central sensitisation. This occurs when the central nervous system becomes more sensitive to signals from the body, essentially turning up the volume on pain processing. As a result, movements or sensations that would normally feel comfortable may become painful or uncomfortable
This does not mean the pain is “all in your head”. The pain is real, but the way the nervous system processes these signals has changed.
Fibromyalgia can affect anyone, although it is more common in women and often develops during adulthood. It may also occur alongside conditions such as rheumatoid arthritis, lupus, axial spondyloarthritis, osteoarthritis, anxiety, depression, or irritable bowel syndrome
How is Fibromyalgia diagnosed?
There is no single blood test, X-ray, or scan that can diagnose fibromyalgia.
Fibromyalgia is usually diagnosed by a GP or medical specialist through careful history-taking, a physical examination, and a symptom questionnaire based on recognised diagnostic criteria. This assessment may include discussing:
● The location and duration of pain
● Whether the pain is widespread
● Fatigue and sleep quality
● Cognitive symptoms, such as “brain fog”
● Other medical conditions
● The impact of symptoms on everyday life
Blood tests or other investigations may sometimes be arranged to help rule out other conditions that could contribute to widespread pain or fatigue.
What is Energy pacing, and how does it help?
Energy pacing involves balancing periods of activity and rest to avoid using all your available energy at once and becoming exhausted for the remainder of the day. It also involves listening to your body’s signals and planning activities strategically so you can conserve energy for both essential tasks and activities you enjoy.
How can Physiotherapy help?
Exercise is an important part of fibromyalgia management, but more is not always better. Exercise that is too intense or progressed too quickly may increase symptoms and contribute to a flare-up.
At Essential Health Physiotherapy, we take a personalised approach to managing your condition. Strategies may include:
● Developing an individualised exercise program based on your symptoms, capacity, and goals
● Gradually building strength, mobility, and exercise tolerance
● Incorporating pacing strategies to help manage fatigue and flare-ups.
● Modifying exercises according to your daily symptoms and energy levels
● Incorporating walking, strengthening exercises, warm-water exercise, Pilates, yoga, or Tai Chi where appropriate
● Using myofascial release or dry needling, where appropriate, to target localised areas of muscular pain or tightness
● Considering co-existing conditions, such as sleep apnoea, depression, anxiety, PTSD, or rheumatoid arthritis, when planning your exercise program
Why is a Multidisciplinary approach important?
A GP can assist with diagnosis and coordinate your overall care. A pain specialist may assist with the management of centrally sensitised pain. Exercise physiologists can provide additional support with exercise and physical activity, while dietitians may help manage symptoms such as irritable bowel syndrome, which can co-exist with fibromyalgia. Other health professionals, such as psychologists, may also provide support based on your individual needs.
Progress is not just about reducing pain. Walking further, standing for longer, improving strength, sleeping better, or returning to activities you enjoy are all meaningful improvements.
At Essential Health Physiotherapy, we can help you find a safe, sustainable, and individualised approach to movement without simply pushing through pain.
If you’re overwhelmed & don’t know how to manage your pain, call us at 07 3132 0898 to get personalised care.
References
Antunes, M. D., & Marques, A. P. (2022). The role of physiotherapy in fibromyalgia: Current and future perspectives. Frontiers in Physiology, 13(13), 968292. https://doi.org/10.3389/fphys.2022.968292
Bhargava, J., & Hurley, J. A. (2023). Fibromyalgia. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540974/
Donvito, T. (2019, December 9). ‘Energy Pacing’ for Fibromyalgia Fatigue: Here’s How It Works. CreakyJoints. https://creakyjoints.org/about-arthritis/fibromyalgia/fibromyalgia-symptoms/energy-pacing -for-fibromyalgia-fatigue/
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2024, May). Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/fibromyalgia
Understanding Diagnosis – Fibromyalgia Australia. (n.d.). Retrieved September 4, 2026, from https://fibromyalgiaaustralia.org.au/patients/understanding-diagnosis-2/
Valera-Calero, J. A., Fernández-de-Las-Peñas, C., Navarro-Santana, M. J., & Plaza-Manzano, G. (2022). Efficacy of Dry Needling and Acupuncture in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis. In International journal of environmental research and public health (Vol. 19, Issue 16, p. 9904). PubMed Central. https://doi.org/10.3390/ijerph1916990
Check our Previous Blogs
- Dizzy When Rolling in Bed? BPPV and Physiotherapy Treatment
- Plantar Fasciitis: The Real Reason That Heel Pain Keeps Coming Back
- 7 Essential Tips to Beat Frozen Shoulder and Get Your Movement Back
- Ehlers Danlos Syndrome (EDS): Exercising Safely With Dysautonomia
- Cervical Radiculopathy: Symptoms, Causes and Physiotherapy Treatment
