Aerobic Exercise for Fibromyalgia

fibromyalgia


Individuals suffering from fibromyalgia will benefit from exercise.





Fibromyalgia classically presents in young to middle-aged women with fatigue, widespread musculoskeletal pain and mood disturbances such as depression. It is a chronic noninflammatory condition thought to be related to abnormal pain processing in the nervous system. Unlike polymyalgia rheumatica, which is an autoimmune disease with similar features of widespread muscle and joint pain, there are no signs of increased inflammation in fibromyalgia. Therefore, taking anti-inflammatories such as NSAIDS (i.e. aspirin or ibuprofen) or steroids are not first line pharmaceutical treatments for fibromyalgia. Instead, antidepressants are often used as a pharmaceutical treatment because fibromyalgia is primarily a nervous system disorder. An even better treatment than antidepressants is exercise. 

The effectiveness of exercise in treating fibromyalgia has been known for decades. The first clues came from a study done in the 1970s in which college students were startled awake in the middle of sleep. Many of the participants began to develop diffuse body aches similar to those experienced with fibromyalgia. However, the investigators noted that the elite runners participating in the study did not suffer these adverse symptoms. In 1994, a clinical trial looked at 99 women with fibromyalgia who were treated with physical training (A randomized, controlled clinical trial of education and physical training for women with fibromyalgia, 1994. Buckhardt, et al.). The clinical trial found that physical training improved patients quality of life and self-efficacy. Six weeks in physical training resulted in significant decreases in helplessness, the number of days feeling bad, physical dysfunction, and pain at tender points. 87% of patients in the physical training group were exercising three times or more per a week.

swimming

Studies have looked at a variety of different types of exercise. Aerobic exercise and mixed modality exercise appears to be the most potent treatment for fibromyalgia. Strength training, resistance work outs and even flexibility exercises have also been shown to be effective in combating fibromyalgia (Exercise interventions in Fibromyalgia: Clinical applications from the Evidence, 2009. Jones KD and Liptan GL). In terms of the specific type of aerobic exercise, research has not been able to dissect a difference between various types of aerobic exercise. A recent study out of Brazil compared the effectiveness of walking and swimming, both aerobic types of exercise, and found both were effective means of alleviating fibromyalgia pain. Both walking and swimming helped individuals with fibromyalgia improve functional capacity and raise quality of life (Swimming Improves Pain and Functional Capacity of Patients with Fibromyalgia: A Randomized Controlled Trial, 2016. Fernandes, et al.). In addition to exercise, improved sleep hygeine can play a role at eliminating fibromyalgia symptoms.

Beyond fibromyalgia, exercise can help patients wth chronic pain syndromes improve their physical capacity. A paper from Cochrane Reviews analyzed 21 reviews with 381 studies totaling 37,143 participants to determine the effect of exercise on chronic pain (Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews, 2017. Geneen, et al.). The conclusion was that exercise can improve physical function in these patients with a minimal benefit toward alleviating the chronic pain. There were few adverse effects of exercise, the authors concluded, another reason to try exercise before starting pharmaceutical treatments when attempting to get rid of chronic pain.

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