Physiotherapy Management of Fibromyalgia: What do we know and how may this Affect Clinical Practice?

Abstract

Fibromyalgia (FM) is a common chronic musculoskeletal pain condition. In addition to pain, patients also complain of excessive fatigue, sleep problems and depression. They also experience exercise-induced pain that probably reduces their physical activity level during their leisure time and limits their activities at home or at the workplace. This is probably the main reason that these patients are often referred to physiotherapy. Several authors suggest that a hypersensitivity of the central nervous system explains the patients' perception of pain to non-painful stimuli, and a hyporesponsiveness of the hypothalamus–pituitary–adrenal mechanisms may explain their feeling of exhaustion. The effects of several non-medical modalities have been examined, and exercise and patient education can be recommended. The purpose of the present paper is to review the scientific literature on FM and assess the consequences this knowledge may have for physiotherapists' management of FM.