What to Expect from Physiotherapy for Fibromyalgia

At the first appointment, the physiotherapist may ask about widespread pain, fatigue, sleep, sensitivity to touch, activity patterns and the tasks you want to manage more comfortably. They may observe posture, walking, joint movement, muscle endurance and how your symptoms respond to activity.

Treatment is often tailored rather than built around forceful hands-on techniques. It can include low-intensity aerobic activity, mobility exercises, strengthening, breathing or relaxation practice, and advice on breaking demanding tasks into smaller parts. The aim is to build confidence and function gradually, not to push through a flare.

Bring a brief record of your energy, sleep, pain pattern and activities that trigger or ease symptoms. Wear clothing that allows comfortable movement. During treatment, describe changes in symptoms clearly; this helps the physiotherapist adjust the exercise level, rest periods or home plan.

A home programme may begin with short, comfortable amounts of movement and increase only when your body is coping well. Use pacing: alternate activity with planned rest, avoid doing too much on a better day, and judge progress by steadier daily function rather than by soreness after one session.

Contact your clinician if symptoms change sharply, a new symptom appears, or exercise causes severe or persistent worsening that does not settle with rest and a reduced programme. Seek urgent care for chest pain, severe breathlessness, fainting, sudden weakness, new confusion, or loss of bladder or bowel control. These symptoms need medical assessment rather than a routine physiotherapy adjustment.

Ask which activities are appropriate for your current energy level, how to recognise an overexertion flare, and how physiotherapy should fit with medicines, sleep support and other parts of your care plan.