Fibromyalgia (FMS) is a primary chronic pain condition (classified in the WHO International Classification of Diseases: ICD-11 Version: 2019). Estimates are that as many as 1 million Australians (3-5%) experience this chronic condition.

Fibromyalgia management is patient-centred; care planning is individually tailored and involves a multi-disciplinary care team.

General Practice Medicare Care Planning, assessments (Medicare Items 721-732) and reviews, provide Fibromyalgia patients with comprehensive assessments that address both the impact of the multiple symptoms and the lifestyle issues which arise from living with a highly debilitating complex chronic condition. Additional services from psychologists and other approved providers can be accessed using a Mental Health Care Plan (Item 271).

General Practice Management is ongoing over multiple visits, to identify treatable symptoms and exclude other overlapping or evolving diagnosis towards stabilisation and rehabilitation.

A comprehensive assessment confirms the diagnosis, identifies predisposing factors and co-morbid conditions as well as establishing a baseline and potential risk factors.

Patients with the multisystem condition Fibromyalgia experience pain within the musculoskeletal system differently from the general population because of dysfunctional pain processing in the central nervous system, that is, sensitisation of neural pain pathways.

Fibromyalgia management uses a targeted problem solving approach towards an optimal combination of treatment therapies directed by patient feedback with good communication.

Management is a combination of pharmacological, non-pharmacological and lifestyle management.

Education and the acquisition of self-management skills are important. Engaging the patient in an interactive process, setting realistic goals and outcomes provides a structure for ongoing management.

As Fibromyalgia patients can be hypersensitive, medical and other interventions use a step-wise approach based on the principle of ‘start slow, go slow‘ (Mayo, 2012).

In Australian General Practice primary care settings, Fibromyalgia patients benefit from early intervention including referrals to preventative and self-management and other community programs. Self-management programs provide reliable information to increase understanding of pain, sleep, nutrition, exercise, wellness and other life-management issues.

The recommended ongoing regular reviews, including monitoring and patient feedback, aid the coordination of treatment towards optimal patient-centred care.

For more information see Fibromyalgia diagnosis and management at HealthPathways South Australia.

The following pages provide information and resources for both providers and patients to improve the management of Fibromyalgia across Australia.