Fibromyalgia: Does exercise help or hurt?

While the pain and fatigue associated with fibromyalgia may make exercise and daily activities difficult, it is crucial to be physically active. Research has repeatedly shown that regular aerobic exercise improves pain, function and overall quality of life.

Won't exercising make my pain flare up?

You may be reluctant to try exercise for fear that it will make your pain worse. But starting low and going slow helps keep symptoms from flaring up. You may want to start with walking two minutes a day and gradually work your way up to 30 minutes two or three times a week.

It's crucial to pace yourself. If you do too much on your good days, you may have more bad days. If an exercise causes you increased pain, reduce the time or intensity of that exercise next time.

What type of exercise should I do?

Different types of exercises can help in different ways. Examples include:

• Flexibility exercises. Stretching exercises can reduce stiffness and improve range of motion. They can be a good way to start and end your exercise routine, to help prevent strain injuries.
• Strengthening exercises. Strong muscles help support your joints and can help reduce fatigue. Your muscles get stronger when they push or pull against a force, such as pulling on elastic bands or lifting weights.
• Aerobic exercises. This type of activity increases your breathing and heart rate, and can improve your stamina. Low-impact aerobic exercises — such as fast walking, biking or swimming — appear to be the most helpful to people with fibromyalgia.

Is water exercise a good choice?

Many people find water exercise to be easier on their joints because the buoyancy of the pool water reduces weight-bearing stress. Some types of these exercises use the resistance of the water to improve your strength and balance. Exercising in warm water can also help relax your muscles and reduce pain.

What are some other options?

Although they are less studied, mind-body practices may help improve symptoms and overall well-being. Yoga and tai chi are practices that combine meditation, slow movements, deep breathing and relaxation. Both have been found to be helpful in controlling fibromyalgia symptoms.