subject: Doctor... What About Exercise For Fibromyalgia? [print this page] Doctor... What About Exercise For Fibromyalgia?
Because the pain of FM may increase with physical activity, many patients with FM become sedentary. This sedentary lifestyle is the start of a downward spiral that leads to deconditioning. Deconditioning then makes symptoms worse at rest and even minimal exertion becomes painful. It is critical to avoid deconditioning because once it occurs, the treatment of FM becomes much more difficult.
Exercise- the proper amount and type- may prevent this deconditioning. Types of exercise that have been evaluated in patients with FM include aerobic exercise, stretching and strengthening, and combined stretching, strengthening, and flexibility exercises.
Aerobic exercise consists of walking, biking, and pool-based forms of exercise. While walking is the most convenient form of exercise, the impact of walking may be too much for some people with FM. Low to no impact types of exercise such as a stationary bicycle, elliptical trainer, and swimming appear to be the best tolerated forms of aerobic exercise.
High intensity exercise where the heart rate is more than 150 beats per minute is poorly tolerated. This discourages the patient with FM and they usually stop exercising. This situation obviously should be avoided.
More moderate forms of aerobic activity where the heart rate is kept to about 55% to 70% of age-adjusted maximal heart rate is better tolerated. Exercise should start well below the capacity of the patient and gradually increase in duration to a goal of 30 minutes of moderate aerobic activity per day.
In our clinic we recommend that patients start with 2-3 minutes a day and increase as tolerated from that point.
Studies have also evaluated strengthening and stretching for FM. While there may be some benefit with these modalities, aerobic conditioning appears to be the type of exercise that has the most value.
As with all programs, treatment needs to be individualized. Some patients may benefit from stretching and strengthening along with their aerobic exercise.
Exercise, in conjunction with cognitive behavioral therapy and medications, works for the majority of motivated patients.
Dr. Wei (pronounced "way") is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland (http://www.aocm.org). He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information:Arthritis Treatment
