How occupational therapy and physiotherapy helps people with fibromyalgia manage chronic pain and other symptoms

Affecting an estimated one million people in Australia, physio and OT therapy programs are often extremely important for helping people diagnosed with fibromyalgia manage their chronic pain.

As a chronic pain condition, fibromyalgia can be distressing and debilitating for sufferers. The widespread musculoskeletal pain and other symptoms they can experience, such as fatigue, muscle stiffness, anxiety, migraine and problems with concentration and memory, can affect their quality of life in a multitude of ways, from finding it a challenge to perform simple daily activities to withdrawing from work and social activities and interests. Not surprisingly, loneliness, isolation and depression are also experienced by people with fibromyalgia.

Fibromyalgia is a pain-processing disorder that affects an estimated one million people in Australia, or around four per cent of the population. People of all ages, including children, can have the condition, which, according to Fibromyalgia Australia, is more common in females and frequently associated with other conditions including arthritis, lupus, chronic fatigue syndrome (CFS), irritable bowel syndrome, Sjogren’s syndrome, and chronic headaches.

For fibromyalgia sufferers, the pain they experience in their muscles, ligaments, and/or tendons can range from mild to intense, yet it is not caused by any physical damage. Some have described the pain as aching, burning, stabbing and shooting, and ranging from constant to intermittent bouts.

What causes fibromyalgia?

While there is no definitive cause of fibromyalgia, research-backed theories as to why people experience widespread chronic neuropathic pain include post-traumatic stress disorder (PTSD), adverse experiences during childhood, neuro-chemical imbalances, brain inflammation, genetics, stress hormones (such as cortisol) and diet.

According to Fibromyalgia Australia, however, most of the research findings attribute the pain sufferers experience to a malfunctioning of the central nervous system (CNS), which is comprised of the brain and spinal cord. Research has also found that a ‘dysfunctional interplay’ between the CNS and peripheral system’s nerves and soft tissues may be the cause of the condition’s body-wide symptoms. This theory has been backed up by brain scans of sufferers that reveal abnormal pain processing.

Fibromyalgia and central sensitisation

This CNS malfunctioning leads to central sensitisation in people with fibromyalgia, which results in a hypersensitivity to stimuli such as heat, pressure and touch. People with fibromyalgia experience a heightened sensitivity to pain, called hyperalgesia, and some can have tactile allodynia, which is a warped perception of pain.

With hyperalgesia, a gentle bump on the arm, for example, is felt as intense pain, and with tactile allodynia an object that doesn’t cause harm, like a feather brushing the arm, is translated as painful. People with fibromyalgia can also experience heightened perceptual sensitivities to external stimuli including odour/scent, light, and noise.

As hyperalgesia is also experienced by people with other central sensitivity syndromes, including ME/CFS, irritable bowel syndrome, and restless legs syndrome, and several other conditions, it can make it a challenge to diagnose fibromyalgia.

What is a fibromyalgia ‘flare’ and how is it triggered?

A fibromyalgia flare, also called a flare-up, is a temporary increase in the severity of pain and other symptoms of the condition.

Flares may be triggered by an infection, trauma, such as an injury, surgery, domestic violence, or the development of another disorder such as rheumatoid arthritis. Stresses vary from person to person and can include illness, travel, over-exertion, changes in medicines, hormone levels, and even the weather.

The benefits of occupational therapy and physiotherapy for people with fibromyalgia

Therapy programs can effectively help people with fibromyalgia manage their chronic pain and reduce its impact on their life.

By addressing the physical and environmental factors that can contribute to chronic pain, occupational therapy and physiotherapy interventions can help fibromyalgia sufferers by:

  • Improving their physical function and mobility
  • Increasing their ability to perform daily activities
  • Reducing their pain and fatigue levels
  • Enabling them to maintain better mental health and emotional wellbeing.

Occupational therapy techniques and interventions to help people with fibromyalgia manage their pain and make it easier to perform daily activities can include activity pacing, mindfulness-based stress reduction, energy conservation and adaptive equipment.

To this occupational therapy plan, a physiotherapist can add specific exercises and massage therapies as part of a multidisciplinary approach to treatment (as offered by Better Rehab). This can help people with fibromyalgia perform daily activities more competently, comfortably and safely. Improving muscle strength and aerobic fitness can improve stability, reducing falls and other injuries, and for some people, reduce their pain intensity, improve their sleep habits and reduce anxiety and depression.

Given these significant benefits, exercise is widely considered one of the best therapies for helping people with fibromyalgia manage chronic pain and perform daily activities. In fact, exercise is more vital for people with fibromyalgia as they have lower aerobic endurance and muscle strength.

Better Rehab’s approach to helping people with fibromyalgia

It is vital that each therapy program is tailored to each person’s needs, taking into consideration their unique medical history, symptoms, lifestyle and personal goals. Therapy should also be adjusted throughout the program to ensure it stays relevant with interventions suited to achieving the best results.

Better Rehab’s physiotherapists and occupational therapists conduct thorough pre-program consultations during which they ask participants about the duration and nature of their flares, the usual triggers and how they impact their lives. Our clinicians also ask what their future goals are, like travelling, getting a pet or returning to work.

These questions enable Better Rehab physios and OTs develop personalised, targeted therapy plans to deliver those outcomes.

If you or a loved one have fibromyalgia, consider seeking the support of a physiotherapist and occupational therapist to help make life better for you!

Better Rehab occupational therapists and physiotherapists can provide Allied Health services to people on the NDIS. To make a booking, fill out and complete our referral form.


Fibromyalgia (

Fibromyalgia | Office on Women’s Health ( The Science of Fibromyalgia – PMC (

The role of physiotherapy in fibromyalgia: Current and future perspectives – PMC (

Effects of a Physical Exercise Program on Patients Affected with Fibromyalgia – PMC (

What is Fibromyalgia – Fibromyalgia Australia

EULAR revised recommendations for the management of fibromyalgia | Annals of the Rheumatic Diseases (

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