Exploring Physical Therapy’s Role in Fibromyalgia Care, With Nicole Zangoglia, PT, DPT

Fibromyalgia is a complex, chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and heightened sensitivity that can disrupt nearly every aspect of a patient’s life. Because no single treatment adequately addresses the full range of symptoms, effective care relies on a multidisciplinary approach. Medications, behavioral interventions, and lifestyle modifications each play a role, but non-pharmacological strategies are becoming increasingly central to improving long-term outcomes. Among these, physical therapy has emerged as a key pillar of care.

Unlike most medical follow-ups, which may take place every few months, physical therapists often see patients 2 to 3 times a week. This frequency allows for closer monitoring, adjustments to treatment plans, and a deeper understanding of how patients are responding to interventions. It also provides consistent touchpoints for education, support, and trust-building, pillars which are critical in managing a chronic condition that may leave patients feeling guarded or overwhelmed. Physical therapists can bridge gaps between the clinical team and the patient, ensuring functional progress aligns with broader treatment goals.

The evidence base supporting physical therapy in fibromyalgia management continues to grow. Aerobic exercise at low to moderate intensity remains the most consistently effective intervention, with additional support for progressive resistance training and aquatic exercise depending on individual tolerance.1,2 Beyond exercise, techniques such as manual therapy, myofascial release, and dry needling can be integrated to reduce pain and improve mobility. Importantly, therapy is not one-size-fits-all: treatment must be individualized based on pain triggers, fatigue levels, and patient goals, whether that means completing daily tasks with less discomfort or returning to higher levels of athletic activity.

HCPLive spoke with Nicole Zangoglia, PT, DPT, a physical therapist with a concierge practice, to learn more about how physical therapy fits within the multidisciplinary model for fibromyalgia, the most evidence-based interventions available, and strategies for tailoring care to each patient’s unique needs.

"You're gaining that level of trust that maybe you wouldn't be getting subjective information if it was a one shot appointment. Or you develop those relationships that does fit a more specific type of patients, [since] they can be more guarded. They're fearful. It's a scary environment to be in. So I've learned that because you have that luxury of being able to build that rapport with them, you can gain a little bit more insight on their condition," Zangoglia said.

References

1. Brooks, A. Home-Based Stretching Program Shows Promise for Fibromyalgia Management. Article. HCPLive. September 15, 2025. https://www.hcplive.com/view/home-based-stretching-program-shows-promise-for-fibromyalgia-management

2. Johnson V. Aquatic Exercise, Resistance Training Most Beneficial for Reducing Fibromyalgia Pain. May 8, 2025. Article. HCPLive. https://www.hcplive.com/view/aquatic-exercise-resistance-training-most-beneficial-for-reducing-fibromyalgia-pain