Physical and talking therapies for fibromyalgia

Studies tell us that physical and talking therapies are often a better way of managing fibromyalgia than medication. Pain can affect mood and behaviour, especially if the pain has been there for a long time. Psychological therapies look at how pain affects our thoughts and habits, and how our emotions can affect pain. This includes cognitive behavioural therapy (CBT), a form of talking therapy, that aims to reduce the often overwhelming effects of problems such as pain.

Rachel found that CBT was helpful for her insomnia.

Age at interview 31

Age at diagnosis 29

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Keeping active is an important part of treatment for fibromyalgia and can help relieve pain, as well as prevent other health problems. Physical therapies to help this include physiotherapy and occupational therapy. Physiotherapy aims to help people to stay active and independent. Helpful exercise for people with fibromyalgia includes a combination of aerobic exercise and movements that improve flexibility and strength. Exercise also improves fatigue. Occupational therapy helps people to manage everyday activities around their fibromyalgia, and suggest new ways to get things done.

Relaxation techniques can be just as important as exercise. Good-quality sleep also helps with tiredness and fatigue, and can improve pain. Some people with fibromyalgia find that complementary treatments help their symptoms.

Pain clinics bring together a range of professionals to provide specific treatments or rehabilitation therapies that reduce the effects of fibromyalgia. Pain management programmes can help people to manage pain better and reduce its impact on their life.

George learnt a lot from an 8 week course at the pain clinic it’s fantastic for what you get.

Age at interview 64

Age at diagnosis 50

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In addition to taking various medications (see Medications for fibromyalgia), most of the people we spoke to had tried physical and talking therapies to help with their symptoms of fibromyalgia. These included physiotherapy, hydrotherapy, CBT and other types of therapy/counselling (see also Alternative and complementary therapies). Some accessed these via the NHS, whereas others paid privately.

Physical therapies

People talked about being referred to a pain clinic (which offers a mixture of physical and talking therapies), and also being referred to an NHS physiotherapist or paying privately to see one. Others talked about being referred for hydrotherapy. Some people like Lynn Ann struggled to get a physiotherapy appointment through self-referral and found the system frustrating.

Views were mixed about physical therapies. Some people reported good experiences and felt that hydrotherapy, seeing a physiotherapist and learning about stretching exercises at the pain clinic helped a lot. Others sometimes found therapies like physiotherapy difficult or painful. People often commented on the importance of the person they were being referred to, whether for physical or talking therapy, actually knowing something about fibromyalgia.

Emma is still to attend a 10 week course at the pain clinic where she’ll learn about exercises and mindfulness.

Age at interview 40

Age at diagnosis 38

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Lyn pays privately to see two physiotherapists she thinks they’ve helped a lot.

Age at interview 68

Age at diagnosis 50

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Aleysha feels that physiotherapy has helped a lot, although she prefers to see a sports physiotherapist.

Age at interview 23

Age at diagnosis 22

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Liz found physiotherapy painful and didn’t feel that the pain clinic offered her what she needed.

Age at interview 66

Age at diagnosis 47

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Lynn Ann says she was just given a sheet with exercises to do. She didn’t feel she developed a good rapport with the person she saw.

Age at interview 53

Age at diagnosis 44

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Karen struggled with the exercises his physiotherapist wanted her to do.

Age at interview 33

Age at diagnosis 30

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Talking therapies

People talked about being referred to a range of professionals for talking therapy, psychiatrists, psychologists, other kinds of counsellors/therapists, mental health specialist nurses and occupational therapists, and also support from their GP to talk about their mental health. Some specialist staff were located within pain clinics.

People sometimes described a difficult process of trying to find the right person to talk to, being passed from one professional to another, having to wait a long time, and then sometimes being told they were not in the right place or there was nothing/nothing further they could do for them.

Mary was referred to a psychologist who said There is nothing I can offer you herethat you’ve not done before.

Age at interview 59

Age at diagnosis 43

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Over the years, Chrissie has tried Cognitive Behavioural Therapy (CBT) and seen a variety of therapists. She says it can take a long time to talk to someone.

Age at interview 27

Age at diagnosis 23

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People were concerned that there seems to be limited funding for talking therapies on the NHS, leading both to long waits and limited amounts of sessions once you have accessed the service.

Alexis thinks that the number of counselling sessions offered on the NHS is not enough.

Age at interview 24

Age at diagnosis 23

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Views were mixed about talking therapies. Some, like Aleysha, Rachel and Lynn Ann found them useful and Michael could see their potential for helping people with fibromyalgia. Others felt less positive about therapies like CBT. Catherine was offered CBT for her fibromyalgia. However, she strongly believes that talking about her pain is not going to be particularly helpful for her because ‘I know I’m in pain, I don’t need anyone to confirm that.’

Aleysha has a good relationship with her latest counsellor and GP as they seem to accept you are in pain.

Age at interview 23

Age at diagnosis 22

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Lynn-Ann says she has a good relationship with her psychiatrist you’re not just a patient, you’re a person to them.

Age at interview 53

Age at diagnosis 44

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Michael can see the potential for CBT to be useful.

Age at interview 63

Age at diagnosis 61

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Catherine doesn’t think talking about her pain is going to be particularly helpful for her.

Age at interview 67

Age at diagnosis 64

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People felt the most useful advice they could give to others was to learn what works for you and listen to your body.

Liz has learnt to manage her symptoms. She avoids a full on exercise class as this can trigger her symptoms.

Age at interview 66

Age at diagnosis 47

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Medication for fibromyalgia

There are a number of treatments and therapies to manage the symptoms of fibromyalgia, such as pain, sleep problems or depression. This may include drug...