Fibromyalgia: Exercise helps — here’s how to start

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If you have fibromyalgia and you’re in pain, exercising is probably the last thing you feel like doing. But experts say it’s actually one of the most effective strategies you can try to help manage this chronic pain condition.

Yet many people with fibromyalgia already struggle to get through their regular daily activities. Adding exercise on top of that may seem insurmountable. And pain and exhaustion can make it difficult to start and stick with regular workouts. 


Getting started

It’s natural to worry that any exercise will make your pain worse and leave you wiped out. But know that adding more physical activity into your day may actually decrease your pain, improve your sleep, and give you more energy.

So, how does a worried person with fibromyalgia get started? You might want to talk with your doctor about your current medical therapy when you’re planning to begin exercising. Questions to consider: Should I take my medications at different times of the day? What can I do either before I exercise or right after to minimize symptoms?

Take it slow

When you are ready to begin an exercise program, start slowly. Taking a small-steps approach to beginning an exercise plan can help. Add activity in small doses, every day if you can. Then build up your activity slowly over time.

For example, if you walked for 10 minutes today, try 11 minutes — a 10% increase — a week later. This approach is especially important for avoiding a phenomenon called post-exertional malaise (PEM). Many people with fibromyalgia have this problem. When they feel less pain or more energy, they may try to get things done that they have been unable to do because of symptoms. Often, they don’t realize when they are doing too much at once. They may wind up feeling so exhausted that it takes days or longer to recover. This is PEM, better known to people with fibromyalgia as a “crash.” A gradual approach to exercise can help prevent it.

Choose activities carefully

In addition to gradually increasing movement over time, also try to choose activities that won’t put too much strain on your body. Experts typically recommend any low-impact aerobic activity, such as walking, swimming, or cycling. Your doctor may advise you to work with a physical therapist on exercises specifically aimed at reducing pain and stiffness and improving function. This may include stretching and strengthening as well as aerobic exercise.

Another form of exercise that has shown promise for people with fibromyalgia is tai chi. This ancient Chinese practice originated as a form of self-defense. It involves slow, deliberate movements and deep breathing exercises.

One 2018 study in The BMJ looked at 226 adults with fibromyalgia. Researchers assigned 151 members of the group to practice tai chi once or twice a week for either 12 or 24 weeks. The other 75 study participants did moderate-intensity aerobic exercise twice a week for six months. Researchers found that tai chi was better at relieving fibromyalgia symptoms than aerobic exercise.

Some limited evidence also suggests that yoga may also help to improve fibromyalgia symptoms, including pain, fatigue, and mood problems.

Whatever activity you choose, remember to be patient with yourself. Short-term setbacks may occur, but being patient and working to overcome them can help you make long-term progress.