Fibromyalgia

The widespread body pain of fibromyalgia makes exercise tough to face

Fibromyalgia affects about 2 percent of the U.S. population--more women than men--and often, those who have the condition are afraid to exercise because they fear worsening their symptoms. But experts say that regular physical activity actually helps fibromyalgia sufferers. The problem? The condition's hallmarks--widespread body pain and fatigue--make it tough to work out.

So how can people with fibromyalgia be encouraged to exercise without fear of making their pain and fatigue worse? A new study shows that taking small steps can help improve pain and functioning of those with fibromyalgia, as long as it's done in moderation.

The goal of the new study, published March 29 in Arthritis Research and Therapy, was to "see if we can get (people with fibromyalgia) to be more active throughout the day," says Kevin Fontaine, associate professor of medicine in the division of rheumatology at the Johns Hopkins University School of Medicine (Baltimore, Maryland). "The goal is to get them to accumulate 30 minutes of activity most days of the week," which can be accomplished in two-to-three-minute increments over the course of the day.

The study's 84 participants were randomized to a "lifestyle physical activity" group or to a control group. Those in the lifestyle group--who, for example, were encouraged to walk more and take the steps instead of the elevator--increased their average daily steps by 54 percent by the end of the study and reported improvements in physical functioning and less pain.

"Even if they just walk to their mailbox, that's better than doing nothing," Fontaine says. "If they do a little bit, they realize that they can manage the pain."

Still, because fibromyalgia symptoms can vary from day to day, each individual has to know his or her own limitations.

"People have good days and bad days, and on good days, they tend to overdo it," Fontaine says. "So if you're having a bad day, try to do a little bit, and if you're having a good day, don't do too much."

Fontaine says that anyone with fibromyalgia can make the small daily lifestyle changes that the study showed can help. He recommends the following six activities to get started, done at a pace intense enough to make you breathe heavily but not so much so that you can't hold a conversation:

1. Buy a pedometer, and walk more. Walking is a total body exercise, and you can moderate the pace and control the intensity, Fontaine says. Wearing a pedometer allows you to easily monitor your progress.

2. Move around while watching TV. Raise your arms over your head, or move them from side to side, Fontaine advises. Or sit in a chair and lift your legs one at a time at the knee. Other options: Make circles with your arms for a minute or two while sitting in a chair. The goal is "even on your worst day, try at the end of the day to say to yourself, 'I did something,'" he says.

3. Take the steps. If you work in an office building, take the stairs instead of the elevator once or twice a day, adjusting your routine based on what's easier for your body. For example, if you find going up the steps to be easier than going down, take the steps up and the elevator down. "Stairs are one of the more intense daily lifestyle activities," and you can build up your tolerance over time, walking two to three flights after several weeks even if you can't tackle one flight at the beginning, Fontaine says.

4. Do yardwork or garden. But make adjustments to fit your needs. That means if your back tends to bother you, consider sitting on a bench while gardening rather than bending over while standing up. Also, "if you have a big yard and you can't do your whole yard at once, just spend five minutes using the mower" at a time, Fontaine suggests.

"One of the problems is that people spend the whole day doing yardwork, and then they have a flare-up for the next few days," Fontaine says, so instead of doing four hours of outside work at one time, break the task up into pieces--say, 20 minutes at a time three or four times per week until the work is completed.

5. Do housework--and make it fun. Turn on music while you vacuum or clean so you move a bit quicker while you work.

"Whatever activity you're doing, think of a way to make it a little bit more taxing than it would be otherwise," advises Fontaine.

6. Finally, if you'd like to step up your routine a bit but don't feel ready for joint-pounding exercise, consider water or aqua exercise. Warm water can be especially therapeutic, Fontaine says. A 2008 study published in Archives of Physical Medicine and Rehabilitation found that exercise in a warm pool three times a week for 16 weeks improved many fibromyalgia symptoms in a group of previously unfit women.

HOW BAD IS YOUR PAIN?

Ask yourself these questions to help evaluate whether you need treatment for chronic pain:

1. Is your pain interfering with multiple activities (work, school, social life)?

2. Does your pain interfere with sleep?

3. Does your pain make you feel sad or depressed?

4. Is your pain interfering with your relationships with significant others?

If you answer yes to one or more of these questions, it may be time to talk with your doctor about treatment options. These questions are not intended to be used in place of medical advice or treatment. Please consult your personal physician.

 

 

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