Jennifer Rowland, Ph.D.

Fibromyalgia is a chronic condition associated with muscle, joint, or bone pain (Wolf et al, 1990), fatigue, and multiple 'tender points' in localized areas that may include the neck, spine, shoulders, and hips. It affects more females than males (9:1), is most common in adults between the ages of 20 and 50, and is diagnosed in 3 to 6% of the population. Several studies have provided evidence that regular exercise reduces pain and fatigue while improving sleep and mood for people with fibromyalgia (O’Connor et al., 1995; Valim et al., 2003).

Benefits of Exercise on Chronic Pain

Overall, exercise improves chronic pain by improving flexibility, strength, mobility and secondary musculoskeletal complications resulting from pain. Exercise can also help to control weight gain resulting from inactivity, which can contribute to painful joints (Hall & Brody, 1999). Aerobic and stretching are two types of exercise that have been shown to manage pain for people with fibromyalgia, although the intensity will depend on the individual’s tolerance level.

Aerobic Exercise Benefits

Aerobic exercise is characterized by activities that increase the pulse rate to between 60% and 70% of your age-predicted maximum heart rate and cause it to remain increased over an extended period of time. Age-predicted exercise heart rate is calculated by subtracting your age from 220 and multiplying this number by .60 (for 60%) and .70 (for 70%). Guidelines from the American Council on Exercise (ACE) recommend low impact exercise such as walking and warm water aerobic programs and warn against high impact activities (such as jogging or certain high impact aerobics classes) that may make symptoms worse. In addition to walking, other low impact aerobic activities include cycling.

Warm Water Exercises

Gusi et al. (2006) found that women with fibromyalgia who performed 12 weeks of waist-high warm water aerobic and strengthening exercises three times a week reported reduced pain and increased strength. The one hour exercise sessions included: 10 minutes of warming up with slow walking and mobility exercises, 10 minutes of aerobic exercises at 65-75% of maximal heart rate, 20 minutes of overall mobility and leg strengthening exercises (4 sets of 10 repetitions), another 10 minutes of aerobic exercise, and 10 minutes of cooling down with low intensity exercise. However, an important finding among this group was the return to pre-exercise pain levels once the exercise was stopped for a period of 12 weeks following this training program. This provides evidence of the importance of maintaining a regular exercise program.

How to Begin an Exercise Program

Resources are available at www.ncpad.org for tips on beginning an exercise program. These guidelines include:

• Start slowly, especially if you have been sedentary for a long period of time.
• Do your stretching after you have warmed up.
• Exercise classes sponsored by the Arthritis Foundation may be helpful in decreasing painful symptoms (local listings have information about pools and exercise classes in your area). For information about this, use the search engine on NCPAD’s website.

Your Feedback is Encouraged

I encourage you to write to me with suggestions for future column topics or to comment on the information provided in this column. You can reach me by e-mail at jenrow@uic.edu.