Rethinking physiotherapy for patients with fibromyalgia - lessons learnt from qualitative studies

Abstract

Background: Fibromyalgia (FM) is characterized by chronic, widespread musculoskeletal pain, extensive fatigue and an array of other symptoms. Cure is not expected, and patients have to learn to live with the illness. During the last years several studies have examined how it is like to live with FM from a patient’s point of view. These findings may help physiotherapists to better understand the challenges faced by patients.Objective: To describe what it is like for patients to live with FM and discuss how this may inform physiotherapy practice.Design: A systematic literature search of qualitative studies up till May 2016 was conducted, and 93 papers were read. The focus was on patients’ experiences of symptoms and how they managed everyday life.Results: Incomprehensible, unpredictable symptoms of FM intrude and disturb everyday life. The body is constantly monitored by patients on a day-to-day basis according to fluctuations in pain and energy levels, and habits and routines of daily life are adapted to these shifts. With other words, the connection between body, self and daily life is ruptured. In contrast, those having recovered from FM had found out what they could tolerate during a day and had spent long time in rebuiding a life worth living.Conclusion: The present paper presents an argument that living with FM calls for a rather complex personal healing process that should be recognized and supported by physiotherapists.