What Is Multimodal Treatment for Fibromyalgia?

By Nicole Villeneuve

Published December 21, 2022

Treatment for Fibromyalgia

As knowledge about fibromyalgia has progressed, so has our understanding of treatments. Today, many fibromyalgia specialists will recommend a multimodal treatment protocol, or a treatment that includes several different therapies, rather than a single approach to treating fibromyalgia pain.

In this article, we’ll look at several different types of fibromyalgia treatments that might be included in a multimodal treatment plan—pharmacological, behavioral, and physical—and why specialists often counsel patients that the best fibromyalgia treatment includes a combination of all three.

Pharmacological Treatment for Fibromyalgia

There are three medications that have been approved by the Food and Drug Administration (FDA) for fibromyalgia:

  • Pregabalin (Common brands: Lyrica)
  • Duloxetine (Common brands: Irenka, Cymbalta)
  • Milnacipran (Common brands: Savella)

These medications are relatively new fibromyalgia treatments, all of them having received FDA approval after 2000. A generic version of the extended-release formulation of pregabalin was made available in the United States as of April 2021, making it one of the latest fibromyalgia treatment options in this category.

Although these drugs are the only ones that have been FDA-approved for fibromyalgia, many different medications are commonly used off-label for fibromyalgia to treat the symptoms and pain, including a variety of other types of antidepressants or novel agents.

Medication therapy is not mandatory for the treatment of fibromyalgia pain, because of the limited efficacy of any one individual drug when it comes to pain reduction. That’s why experts often advise that the most effective treatment for fibromyalgia will include non-drug treatments as well, either with or instead of medication options depending on the patient.

Non-Drug Treatment for Fibromyalgia

Medications alone don’t tend to improve pain and quality of life to a significant degree for fibromyalgia patients, and they can have adverse side effects. That’s why a variety of non-medication treatments are often recommended by fibromyalgia treatment specialists, to use in parallel with medication therapy and to provide improvement in pain and other fibromyalgia-related symptoms like sleeplessness or anxiety.

Some patients prefer these non-drug treatments or “natural” remedies because they can have fewer side effects compared to medications.

Behavioral Treatments

Behavioral treatments include things like cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT). These therapies focus on empowering the patient through techniques that improve patients’ coping mechanisms with regards to their pain, so that they’re able to live their best lives and live the values that they deem important.

Cognitive behavioral therapy (CBT) and Acceptance and Commitment Therapy (ACT) have been shown in multiple well-designed studies to be helpful for managing fibromyalgia-related and chronic pain. Some outcomes in clinical trials include:

  • 74% of patients reported better sleep quality (vs. Control) 
  • 76% of patients no longer affected by clinical depression 
  • 60% of patients no longer affected by clinical anxiety

Physical Treatments

Physical modalities—activity, exercise, movement—can often be used interchangeably as fibromyalgia therapies. The focus is on moving in a way that feels good to the fibromyalgia patient, so that they’re able to keep their muscles strong, and boost endorphins that come from movement.

Often, these physical modalities can be used in tandem with behavioral therapies like CBT and ACT. Mindfulness strategies and acceptance strategies can help people with fibromyalgia not only navigate their daily activities, but also increase their ability to do other types of things that are important to them, whether it be attending social events, being able to go to a sporting event that they enjoy, or more physical activity.

Increasing Access to Fibromyalgia Treatments

Because there is a lack of providers and clinicians who are specialized in delivering comprehensive long-term management to treat chronic pain in fibromyalgia patients, access to care can be challenging. In addition, when people are experiencing pain, it can be hard for them to get to a provider and make it to their appointments to receive care.

Behavioral and physical treatments, in particular, can require regular visits to a healthcare provider. The amount of time it takes for patients to undergo this type of therapy may not be consistent with the lives they lead.

With the advent of telemedicine and digital therapeutics for fibromyalgia, more people have the ability to access specialty care in the comfort of their own home, without having the added burden and stress of driving, taking time off of work, or the travel expense to visit a provider.

Nicole Villeneuve

Swing Marketing Director

Nicole Villeneuve is a Marketing Director at Swing Therapeutics, which develops digital therapies that help people with chronic illness live their best lives. She has written about behavioral health and chronic conditions for over a decade, and is a CDC-certified lifestyle coach for the National Diabetes Prevention Program.

Read Full Bio

Related Posts


Fibromyalgia Tests: Fact vs. Fiction

Many medical conditions are diagnosed through a diagnostic test, such as a laboratory blood test or imaging scan. These tests…

Read the Article


Is Fibromyalgia an Autoimmune Disease?

If you’re living with fibromyalgia, you have probably wondered what causes it. Illnesses can be treated more effectively once researchers…

Read the Article


Root Causes of Fibromyalgia: Exploring 5 Commonly Cited Causes

If you’re exploring a fibromyalgia diagnosis or experiencing chronic pain, you’re likely considering where it all started. Maybe you’ve had…

Read the Article


What Helps Fibromyalgia Pain? A Review of the Research

If you’re experiencing fibromyalgia symptoms, you may feel like you’ll try anything to get relief. You may have tried lots…

Read the Article


Doctors Who Treat Fibromyalgia: Who Can I See?

If you think you might have fibromyalgia, or if you’ve recently been diagnosed with the condition, you’ll want to establish…

Read the Article


The Widespread Pain Index and Fibromyalgia Pain Areas

If you’re living with fibromyalgia, you’re probably already well aware that pain is its main symptom. Fibromyalgia can cause pain…

Read the Article


What Medications Are Recommended for Fibromyalgia?

There are three FDA-approved medications for treating: pregabalin, duloxetine and milnacipran. Discover what they are, how they work, and what…

Read the Article


Fibromyalgia Flare Ups: What Causes Fibro Pain and Flares?

Fibromyalgia is a dynamic condition, and pain severity can change from day to day. While flares and triggers can vary…

Read the Article


Cognitive Behavioral Therapy for Fibromyalgia

What Is Cognitive Behavioral Therapy? Although it started as a treatment for what we would now call post-traumatic stress disorder…

Read the Article

Start your free assessment to see if Swing Care is right for you.

Get Started
LegitScript approved
Back to top