#ChosePT for Fibromyalgia

#ChoosePT for Fibromyalgia

Fibromyalgia syndrome (FMS) is a complex disorder generally characterized chronic widespread pain in at least 11 of 18 tender points. It can also be described as a sensitization of the central nervous system. Central sensitization can alter sensory processing, anti-nociceptive mechanisms (anti-pain mechanisms), and increased pain facilitating pathways among other changes to neural input and outputs. When central sensitization occurs, little stimulus is required that results in a large output of pain. This can also alter the tolerance of pain to associated areas as well as the stress response system. Although anyone with excessive physical and emotional stress can have a negative effect on the body, an individual with a sensitized nervous system may respond/react differently under the same conditions. In addition to signals sent from the brain, repetitive input signals from musculoskeletal injuries and traumas can also overload the central nervous system.

Despite the complexity of this diagnosis, a physical therapist can help! Read below for some interventions your physical therapist can provide

Treatments by your physical therapist can include:

Education on pain and self-efficacy. Poor understanding of pain may lead to abnormal attitudes and behaviors towards pain.

Activity management is vitals as there is a decreased tolerance to activity as well as altered recovery. Exercises including self-pacing techniques such as monitoring intensity, duration, and rest periods are excellent methods to achieve this.

Passive treatment can include soft tissue mobilization to superficial and deep layers, myofascial release, and neurovascular mobility to decrease sensitivity of the nervous system. This can be done to retrain the brain and homunculus in attempts to restructure the pathways that have become inhibited or facilitated.

Stress management/relaxation techniques can include cognitive-behavioral therapy which is aimed to identify stressors and gradually increase exposure in order to habituate the stressful factors and build tolerance. It also assists in increasing awareness of their responses to stressors to be able to develop techniques to overcome and manage stressful situations.

Exercise. There is strong evidence to support the implementation of aerobic exercises to train the cardiovascular system during different activities and target a variety muscles. It is common in patients with FMS to have pain during activity, but closely working with your therapist to tailor the exercises to determine a sufficient degree of challenge can greatly affect pain as well as tolerance to the exercise.

Additional information regarding FMS can be found at the link below or you can discuss this further with your personal physical therapist!


Jo Nijs, Kaisa Mannerkorpi, Filip Descheemaeker, Boudewijn Van Houdenhove; Primary Care Physical Therapy in People With Fibromyalgia: Opportunities and Boundaries Within a Monodisciplinary Setting. 2016; 90 (12): 1815-1822. doi: 10.2522/ptj.20100046
Author: Dr. Esther Kim, PT, DPT