It affects around 2-5% of the population. (1)
It is under-diagnosed, because of the vagueness of many of the symptoms. For those who do get a correct diagnosis, it can take years.
Fibryomyalgia was originally though of as a rheumatic (joint) condition.
Now, research has shown it is mainly a problem with the central nervous system (the brain and spinal cord).
Due to the lack of understanding of the condition, there aren’t many treatments that provide good, long term, results.
Currently, the best treatments for fibromyalgia are (2):
- Stress management and relaxation techniques
- Cognitive behavioural therapy
- Manual and physical therapies
- Certain medications
The Benefits of Exercise for Fibromyalgia
Of the treatments above, exercise is low cost, available to all and has minimal side effects. This makes it an excellent primary management strategy for chronic pain.
Exercise has the potential to improve fibromyalgia. It works by a combination of both specific and non-specific effects.
Some of those effects are:
We don’t know exactly how exercise helps pain. We do know there are probably a few different effects involved.
One of the main ones is descending modulation. This occurs when the brain secretes natural pain relieving chemicals. Commonly known as endorphins, they target different nerve receptors, inhibiting potentially painful messages.
Improved Cellular Energy Production
Suffers of fibromyalgia often report increased fatigue. To make matters worse, many have difficulty getting restful sleep.
Exercise can help increase mitochondrial density (3). Mitochondria are the cellular power plants. They convert glucose into ATP, which cells use to fuel their activity.
In theory, increasing mitochondrial density should improve cellular energy production.
In practice it’s kind of like installing a bigger engine in your car. It has the potential to make it go faster, but everything else need to work well too.
Better Hormonal Balance
Regular exercise improves hormonal balance. It decreases catabolic stress hormones and increases anabolic sex hormones.
This balance is thrown off in people with fibromyalgia.
Better hormone balance leads to a more positive psychological state, improved emotions and healthier physiology.
It’s not hard to see how this could benefit a chronic pain condition like fibromyalgia.
Stimulates the Lymphatic System
Many people are aware that exercise improves blood flow. But, few know that exercise also improves function of the lymphatic system.
The lymphatic system is the body’s “waste management system”. It has a network of vessels all around the body, like arteries and veins. These vessels remove cellular and immune system “waste” from the local area.
When you are sick, your lymphatic system becomes more active, and you can often feel your lymph nodes.
Of interest to fibromyalgia sufferers, the brain, hormonal and immune systems are connected. One of the ways they communicate during an immune response is via the sympathetic nervous system (SNS). (4)
It’s a complex relationship, but the stress hormones can both improve or inhibit immune functions.
With fibromyalgia, one of the mechanisms involved is an overactive SNS.
By stimulating the lymphatic system, we can influence the SNS. However, we have to do it in a way that does not cause a flare up.
How To Exercise With Fibromyalgia
Exercise with fibromyalgia is often challenging for two main reasons:
1. Pain (both during and/or after)
Pain is an obvious barrier to exercise for someone with a chronic pain condition. Sometimes though, you need to endure the early pain to get a bigger benefit in the long term.
To deal with this, research on chronic pain suggests a pacing approach. Pacing means doing a little at a time, within your limits, and increasing that amount at a gradual pace.
A good exercise program for fibromyalgia should have pacing built in. It will also have a “plan B” for those days when you feel terrible, and don’t want to do anything, but know you should.
Fatigue is the second big issue associated with fibromyalgia.
As mentioned, exercise can potentially help reduce fatigue in the long term.
In the short term, focus on pacing during exercise. Then afterwards, look to enhance your recovery as much as possible to help minimise fatigue.
If you avoid common exercise mistakes, you can get the benefits of exercise for fibromyalgia whilst minimising flare ups.
What Type of Exercise Is Best?
Cardiovascular exercise is a great place to start with fibromyalgia.
It is easy to scale the intensity and volume to appropriate levels, and there are a variety of ways to do it.
- Elliptical machines
Resistance training offers complementary benefits for fibromyalgia. Increased strength helps to maintain function throughout your life.
Resistance training is also very scalable, making a pacing approach easy to implement.
A good approach, depending on your personal preferences, would be to incorporate both.
If you do, and you apply pacing principles to your chosen activity, you can’t go wrong.
This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.
This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.