Exercise for Fibromyalgia Pain and Fatigue

No doubt about it—physical activity can be tough when you've got fibromyalgia. You can't do much on the days you're fighting fatigue. And on the days you're feeling well, you may be tempted to overdo it. But to cope, you've got to exercise, even if it's just a little, because a complete standstill is likely to make your symptoms worse. There's no one-size-fits-all exercise guideline, and strenuous activity may aggravate your fibromyalgia. So you've got to be smart. With a bit of trial and error—and guidance from your doc—you can find activities that make sense for you, as well as how often and how intensely to do them.

Whether or not you're a water lover, you'll want to at least try water exercises. Numerous studies report that this form of low-impact exercise—especially when done in warm water—can help reduce fibro pain and stiffness, as well as fatigue and depression in many people with fibromyalgia. You don't have to endure the monotony of swimming laps if that's not for you. There are a variety of fun workouts to choose from, including aqua aerobics, underwater walking or jogging, strength training, stretching and water-based relaxation therapies like yoga, tai chi and Watsu. Some spas and fitness centers even offer pool-based Zumba, hip hop and country-western line dancing.

Plug into a beginner fitness video a few nights a week. Research suggests that cardio-based aerobic exercise can help to curb fibromyalgia symptoms, including pain, fatigue, anxiety and depression. Better yet, the options are endless. If you prefer group workouts, you can choose from a variety of low-impact aerobics classes, step classes, spin classes, kickboxing classes and more. Like solo workouts? Try treadmill walking, elliptical training, or even roller-skating, hiking or biking. Whatever exercise you try, check with your doctor first, and stick with low-impact aerobics done at light to moderate intensity. No aggressive workouts that could exacerbate your symptoms.

You don't have to be a body builder. But lifting light weights or doing other types of resistance-based strength training might improve your fibromyalgia symptoms. Fewer fibromyalgia studies have been done on strength training than on other exercise forms, but resistance training shows equal promise in its ability to relieve fibro pain and fatigue, improve sleep, reduce the number of tender points, and dampen depression in people with fibromyalgia. Strength training also may prevent weakening and loss of muscle mass (atrophy) to boot.

Lace up your walking shoes and hit the sidewalk. Research suggests that mild to moderate intensity walking may dial down fibro pain and fatigue just as well as other forms of aerobic exercise do. But ask your rheumatologist or physical therapist how fast, how far, and how often you should walk when starting out. And build up your walks gradually. How much you should ultimately walk will depend on several factors, including your age, your fitness and activity levels, the severity of your fibromyalgia symptoms, and whether the activity worsens or improves your fibro pain and fatigue. Keep in mind that it’s probably also best to do mini walks here and there rather than take one long walk.

Compared with aerobics and strength training, less research has been done on the benefits of stretching for people with fibromyalgia. But some findings do suggest that stretching exercises, including those used in physical therapy and yoga, may help improve fibromyalgia symptoms, such as reducing overall stiffness, improving muscular flexibility and enhancing well-being. Consider consulting with a licensed physical therapist for prescribed stretching exercises that are safe for people with fibromyalgia.

If you're new to exercise or just not sure what's safe for you, ask your doctor or rheumatologist for a referral to a licensed physical therapist—not a fitness trainer—who is trained in helping people with fibro. Working closely with this kind of expert may help prevent you from aggravating your fibromyalgia symptoms with the wrong kind or intensity of exercise. That's especially true if you have other physical conditions or injuries to work around. Plus, some studies do suggest that physical therapy helps improve flexibility and range of motion, emotional well-being, and muscle loss and weakness in people with fibromyalgia.

These two forms of ancient Chinese medicine combine gentle martial-arts-based movement, postural exercises, breathing exercises and mindfulness meditation. Tai chi is one of many types of chi-gong (qigong), and both disciplines were developed centuries ago as ways to enhance the body's vital life energy (or chi) as a way to heal disease and increase well-being. More study is needed to confirm whether the exercises have a direct effect on fibro pain, but findings suggest they might enhance the ability to cope. And both exercise forms have helped relieve anxiety and depression in people with fibromyalgia. Tai chi seems to enhance balance and lower body flexibility as well.

Being a faithful follower of your exercise program is what brings continuous results. Research suggests that the symptom-improving benefits of any exercise program may take up to 4 weeks to fully kick in, so be patient. And remember, whether you're just starting out or have been at it for a while, if exercise ever hurts or makes your fibro symptoms worse, stop. Break it up. Exercise in small spurts. And keep it low-key. The last thing you want is to overdo it. And if you can't find anything that works for you, check in with your doctor or physical therapist as soon as possible to find out what other fibromyalgia treatments you might need to get back on a more active path.