In spite of considerable research regarding Fibromyalgia, many health professionals still don’t understand it well enough to assist their patients. Seek out health professionals who understand that Fibromyalgia:

• Is a real, biological disease involving a range of body systems
• Is not depression or a psychiatric illness
• Involves genetic, gut, mitochondrial and heart dysfunction

There are a number of healthcare professionals who may be involved in helping you manage your fibromyalgia.

General Practitioners

Most people will have seen their GP with a range of health problems. He or she should be your first point of contact for any concerns you have about your health.

The following symptoms are all part of Fibromyalgia:

• Chronic widespread pain in the muscles, ligaments and tendons
• Sleep disturbance, non-restorative sleep
• Fatigue
• Musculoskeletal stiffness
• Cognitive dysfunction
• Other symptoms (see Patient Leaflet 3 Fibromyalgia Canadian Multisystem Questionnaire, based on Canadian symptom criteria)

It is important that you find a GP who can diagnose your fibromyalgia early because early diagnosis and treatment are critical to reducing the impact of the disease.

Your GP can help you coordinate your overall health care, including making referrals to specialists if needed.

Allied health professionals

A person with a chronic disease such as fibromyalgia is entitled to a Medicare Enhanced Primary Care Plan. This plan will allow you five visits per year to a range of Allied Health Services. Your GP may have a practice nurse who can provide information and coordinate your care with the other members of your healthcare team.

• Dieticians are experts in food and nutrition. They provide advice about healthy eating, weight loss and diets for medical conditions, such as diabetes. Many people with fibromyalgia will have food intolerances and/or food malabsorption’s. Testing for food intolerances (IGG) and food malabsorption (lactose and fructose) can be performed in the clinic or in your own home.
• Exercise physiologists can give you advice about exercise, including the best types of exercise for your health and ability.
• Occupation therapists (OT) can show you ways to make activities of daily living, such as cooking and showering, easier and provide advice on useful aids or equipment. OTs can assess your capacity to manage in your home, work or school setting. Home services can be arranged, such as a shopper, a cleaner, taxi vouchers or Meals on Wheels. Make sure your food intolerances are taken into account.
• Pharmacists can help you understand your medicines (both prescription and over-the-counter) and how to use them safely and correctly. Medications and specialised supplements may be an important part of your treatment.
• Physiotherapists can provide a specialised bio-mechanical assessment and advise you on exercise, posture and ways to relieve pain. They may also use treatments to keep your joints and muscles flexible. Before starting, ensure that your physio is experienced in working with fibromyalgia patients. Myofascial and trigger point therapy are particularly relevant.
• Podiatrists specialise in conditions affecting the feet. They can help with footwear, nail care and orthotics (shoe inserts).
• Psychologists & counsellors can teach you ways to cope with pain and illness and work through the grief and frustrations that come with having a chronic disease. To help you make these adjustments, your GP can arrange a Medicare Mental Health Care Plan. This allows you 12 visits per year to a psychologist of your choice.

Other Health Practitioners

Massage, acupuncture, relaxation, gentle forms of yoga and meditation can be helpful to manage symptoms such as pain, stiffness, stress or anxiety.

Community support and networking groups can provide you with education, low-cost group activities and advice on on-going management of your disease.

Where can I see allied health professionals and how much will it cost?

If your GP refers you to a health professional as part of a care plan, you may be able to have 5 sessions per year funded by Medicare. Ask your GP for more information.

• The public system: Most health professionals are available in the public health system e.g. community health centre or public hospital. There is often a waiting list, and you will usually need a referral from your GP. Their services are usually free or low cost.
• The private system: You can consult any of these health professionals at private clinics without a referral from your GP. The cost varies but may be covered in part by private health insurance.

Medical Specialists

There are few fibromyalgia specialists in Australia however your GP may recommend a specialist to investigate particular symptoms. Your GP can recommend a specialist for you or you may wish to choose your own. Most specialists see patients either at public hospitals or in private clinics. They may charge a fee for your appointment if working outside the public hospital system. Consultations may be lengthy and may involve additional testing. These costs are not yet fully reimbursed by Medicare. Check the likely costs when making an appointment. If cost is a problem, discuss this with your GP.

Be prepared for your consultation

• Think about and write down questions you want to ask
• Consider taking a family member or friend as a second set of ears
• Keep a daily diary identifying your symptoms and score as mild, moderate or severe
• Keep a file of all your tests
• Ask your doctor or health professional to explain any information that you did not understand
• Ask questions, especially about the benefits, side effects and costs of treatments
• Tell your doctor or health professional if you need time to think or to discuss something with family members
• Write down any important information or instructions you are given
• Ask your doctor or health professional where you can learn more about your condition or treatment
• Explain to your health practitioner if you have orthostatic intolerance and may need to lie down in the waiting room or during appointments