Jeanie Lerche Davis
Brunilda Nazario, MD
Not every doctor understands fibromyalgia well -- yet it's critical to find one who is up to date on the latest fibromyalgia treatment and research. Wherever you live, you'll have to do some research to find a health care provider who is the best fit for you.
Here's the good news: "It's easier now to find someone to treat fibromyalgia," says Kim Jones, PhD, associate professor at Oregon Health & Science University School of Nursing and Medicine in Portland.
"Fibromyalgia has come a long way in gaining acceptance in the medical community -- now that we understand the mechanisms of this disease and have treatments proven to help."
Traditionally, fibromyalgia falls under the scope of rheumatologists. But today, primary care doctors, podiatrists, osteopaths, psychiatrists, neurologists -- plus nurse practitioners -- are overseeing long-term fibromyalgia treatment. "People in primary care are learning more about diagnosis and management of fibromyalgia," Jones tells WebMD.
In small communities, finding a doctor willing to handle fibromyalgia treatment has been difficult. In large urban areas, specialists may be easier to find -- but may not take new patients.
Support groups: "Find out who in your town has fibromyalgia and who is taking care of them," Jones says. "Call local hospitals. Ask about support groups for fibromyalgia, lupus, chronic fatigue. People in those groups will know which health care providers treat fibromyalgia."
Don't limit your search to rheumatologists: Many rheumatologists have big, demanding patient loads. Some prefer to treat only autoimmune disorders like lupus and rheumatoid arthritis, Jones says.
Consider the team approach: Ideally, you would like to have one provider take care of you. If you can't get that, the next best option is a treatment team -- a provider who manages your long-term fibromyalgia treatment, plus therapists who address special problems.
For Long-term fibromyalgia treatment: Talk to doctors of osteopathy (DO), primary care physicians, nurse practitioners. If you're seeing a podiatrist, psychiatrist, or neurologist, talk to them about your overall condition. "Very often, patients go to these specialists for treatment of symptoms -- like plantar fasciitis, depression, sleep problems, headaches. They may be open to managing your overall fibromyalgia treatment long-term," Jones says.
"Even if they don't have a great deal of experience treating fibromyalgia, willingness to treat it certainly counts," she tells WebMD. "It makes less difference how many patients they're treating with fibromyalgia, if they're open-minded."
For short-term fibromyalgia therapy: You will likely need physical, occupational, speech, and cognitive therapists who can treat certain aspects of your illness. You won't see them long-term, just for awhile to get exercises you can do on your own. "They can really help with quality of life -- make a big improvement," Jones says.
Physical therapists can treat plantar fasciitis, posture, and other conditions related to fibromyalgia. "It's very important to find someone who is not just focused on sports medicine," she adds. Occupational therapists can make suggestions to minimize stress on certain parts of your body.
Speech therapists who treat head trauma and stroke patients can help fibromyalgia patients with 'fibro fog.' "The therapies they utilize can help with cognitive problems -- memory and thinking difficulties," Jones says. "It's a big quality of life improvement for these patients. There's nothing more distressing than having trouble thinking."
If therapists in the past haven't helped you, don't give up, Jones advises. "Find someone who knows fibromyalgia -- or who at least works with older people. That's a bitter pill to swallow if you're 40 years old, but the exercises they prescribe will be similar."
Check with pain clinics. Some treat chronic fatigue, but not fibromyalgia. Ask if they treat fibromyalgia. How many patients have that diagnosis? Ask if one of the fibromyalgia patients could call you to discuss their experience with the pain clinic. "Pain clinics can be hit-and-miss, whether they treat fibromyalgia or not," Jones says.
Schedule a no-cost interview with each provider who interests you. Make it clear to the receptionist or nurse scheduling appointments that this is not a medical exam -- just an interview. At your interview, provide a short list of your medical problems or symptoms. Be brief. Keep the interview to 10 or 15 minutes.
The National Fibromyalgia Association suggests this list of questions:
After the interview, jot down your impressions. Did this person believe in fibromyalgia? Were your questions answered? Is this a person you feel will listen to you? Trust your gut instinct.
Finding the right person to treat your fibromyalgia is important. Don't give up. Even if you've had bad experiences in the past, things are improving in fibromyalgia treatment. There's a medical professional out there who is just right for you.
SOURCES:Kim Jones, PhD, associate professor, Oregon Health & Science University School of Nursing and Medicine, Portland.National Fibromyalgia Association: "The Perfect Fit."Fibromyalgia Information Foundation.
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