When is physiotherapy recommended for fibromyalgia?

Fibromyalgia symptoms can vary from day to day, so rehabilitation is usually adapted to your energy, sleep, pain sensitivity, and routine. A physiotherapist may teach gentle mobility, breathing or relaxation strategies, low-impact aerobic activity, and gradual strengthening. The focus is on finding a sustainable level of movement rather than testing how much discomfort you can tolerate. Pacing can help separate activity into manageable portions and reduce the cycle of doing too much on a better day and needing prolonged rest afterward.

Tell the therapist about fatigue, poor sleep, headaches, dizziness, and any other symptoms that affect exercise. Keep a simple record of activity and how you feel later, since delayed flares can guide the next adjustment. Use the agreed starting level consistently before adding challenge. Gentle walking, water-based movement, or home exercises may be options, depending on your health and preferences. Do not change several parts of your routine at once without discussing it.

Contact a clinician promptly for a new or rapidly worsening symptom rather than assuming it is fibromyalgia. Seek urgent help for chest pain, severe breathing difficulty, fainting, sudden one-sided weakness, new confusion, or thoughts of harming yourself. Fever, unexplained weight change, swollen joints, or a new neurological problem also warrant medical review.

What type of physiotherapy suits my current energy and pain levels? How will we adjust activity after a flare? Which symptoms should be investigated separately? Can the plan account for work, sleep disruption, or sensory sensitivity? What is a realistic first functional goal?