Finding Support & Help
A list of doctors covered by your insurance company says nothing about the quality of care you will receive for treating your fibromyalgia. Even doctors with great website ratings may not possess the best approaches for tackling fibromyalgia. Yet finding healthcare providers who are willing to work with you to get your symptoms under control is key.
Fibromyalgia is not like most medical conditions. The symptoms are numerous and there are many body systems affected by this disease. It’s a complex illness and treating it may require more than one physician as well as other providers such as physical therapists and counselors. In addition, you need to know about doctor attitudes on fibromyalgia and how it’s generally treated before seeking help.
Primary Care, Pain Specialist, or Rheumatologist?
There are pros and cons to seeing each one of these types of doctors for treatment of your fibromyalgia. In general, a primary care physician (or PCP) who will take on the job of treating your fibromyalgia is ideal. After all, this person is already taking care of your other health issues. However, you may require a specialist who has more time and experience than your PCP has to offer, especially if you are newly diagnosed.
Pain Specialists
Pros:
- These doctors have experience with all the drug and nondrug therapies that may be used to treat fibromyalgia pain.
- They likely have a working relationship with other important healthcare resources, such as physical therapists and counselors.
- If you are currently taking an opioid, this specialist might be more willing to work with you. Also, they may have a few creative approaches that may help wean you off opioids safely. However, don’t be surprised if they have a rule of no opioids on the first date, i.e., first visit.
Cons:
- The weight time to get in to see them can be lengthy.
- Your insurance company may require a referral (probably from your PCP).
- The number of pain specialists is extremely small, and some communities may not have any.
- Due to the limited number of pain doctors, they may employ a team of nurse practitioners and physician assistants. As a result, you may not see the same provider each visit.
- A pain specialist will not take care of your other health needs, nor will they do general check-ups. You still need your PCP for this.
- They may want to perform invasive and expensive procedures, especially if they are in a pain clinic setting.
Primary Care Physicians (PCPs)
Pros:
- Chances are, you already have a working relationship with this doctor, and working with them to treat your fibromyalgia may be easier than starting over with someone new.
- PCPs are covered by insurance, even if you have a co-pay. Overall, they are the least costly option.
- If you give your PCP a chance, they may be willing to work with you on getting your fibromyalgia symptoms under control. If after a few visits you don’t get better (or you get worse), your PCP will be the one who writes the referral to a specialist. Also, if your insurance requires an explanation for the referral, they will be able to document that they tried.
- Most specialists will want to refer you back to your PCP for ongoing care. So, if your fibromyalgia gets worse, this doctor will have experience working with your specialist to treat you.
- You need to see this doctor for all your other medical needs. In addition, they can offer good referrals to other providers, such as pain specialists, physical therapists, counselors, and rheumatologists. It just depends upon your needs.
Cons:
- PCPs must know about so many aspects of medicine, they cannot be expected to be an expert on fibromyalgia, especially given its complexity.
- They tend to be swamped, with the typical visit being 10 minutes. Unless they have a specific interest in fibromyalgia, these doctors may not have the time to fully treat this disease.
- Even if you provide your PCP with an article about a new treatment you want to try, they may not have the time to read it.
Rheumatologists
Pros:
- If you have arthritis or any other rheumatic disease, a rheumatologist may be the best doctor for your fibromyalgia. This is because these other diseases tend to make the fibromyalgia worse.
- The rheumatology journals have featured research articles on this condition since the late 1980s. Most rheumatologists can recognize all your fibromyalgia symptoms and may be the best doctor to treat them.
- Rheumatologists often work with physical therapists because they treat a lot of musculoskeletal conditions. In addition, most of their patients are in pain and often require counseling to help cope with the discomfort.
Cons:
- The type of pain caused by fibromyalgia, along with the various medications used to treat it, differs substantially from arthritis and related diseases.
- Just because a rheumatologist sees a lot of patients in pain, it doesn’t mean that they want to treat fibromyalgia. In fact, a large percentage would prefer to not see fibromyalgia patients.
- Most rheumatologists went into this field because they are fascinated by the science surrounding autoimmune diseases, such as rheumatoid arthritis. Fibromyalgia is not a classic auto-immune disease. So, chances are, it doesn’t pique a rheumatologist’s interest.
Choosing a Physician
Regardless of what type of physician you elect to see (PCP, pain specialist, rheumatologist, or another specialty), you still need to find one. Several fibromyalgia experts offer their suggestions on making the best of your first visit with a new doctor. See our article: Finding a Quality Physician.
Selecting a Physical Therapist
Physical therapists can reduce pain and improve function if they are experienced with treating myofascial trigger points or MTPs. These are the rock-hard areas in your muscles that radiate pain and restrict your movement. Studies show that fibromyalgia patients can identify most of their MTPs. However, finding a therapist skilled at releasing these tight knots takes time.
Ideally, your primary care or fibromyalgia doctor will refer you to a good physical therapist. Once you get a name, call your insurance company to find out if this therapist will be covered and for how many visits. If the therapist is not covered, get a list of those who are and ask about co-pays.
Once you identify a prospective therapist, call to ask the following questions:
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- How long have you been in practice? If they say 40 years, they may or may not be current on the newer techniques for treating MTPs.
- What is your treatment approach to fibromyalgia? You don’t want someone who solely promotes a fitness program.
- What techniques do you use to release MTPs?
- After the initial assessment visit, can you give me an estimate of the number of treatments I might need? Keep in mind that insurance companies limit the number of visits
- Will you also teach me a home program? You may have to ask this question during the first visit.
Once you identify a suitable physical therapist, ask your doctor to send over the referral. Generally, you can’t book any appointments until the therapist receives the referral, and there is a good reason for this. Your therapist may have an appointment opening next week, but your doctor may take longer to write the referral. Until the therapist has the referral, they can’t treat you (unless you bypass your insurance).
Connecting with Others
Talking to fibromyalgia patients is often helpful, especially for those newly diagnosed. It’s reassuring to converse with others to validate that you are not going crazy and that your symptoms are real.
Support groups may be in person or via Zoom. You can usually find out if there is a group in your town by a quick Internet search. One website to check is www.meetup.com.
Another way to connect with others is through our Facebook page. We post regularly on common issues that fibromyalgia patients face. Sometimes, we even add a touch of humor to lighten your day. We welcome you to become a member of AFSA and like us on Facebook.
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Learn all you can about fibromyalgia so you can receive the best quality care. Check the following sections:
Symptoms | Medications | Nondrug Treatments | Muscle Pain Relief | Movement Therapies