Lifestyle Changes

Many studies have shown that exercise is the most effective component in managing fibromyalgia, and patients must expect to undergo a long-term exercise program. Physical activity prevents muscle atrophy, increases a sense of well being, and, over time, reduces fatigue and pain.

Graded Exercise. The basic approach used for fibromyalgia is called graded exercise. Graded exercise means you slowly increase the amount of your physical activity. In a well-conducted 2002 study, 35% of patients who engaged in graded aerobic exercise reported feeling much better or very much better after 3 months. Only 18% of patients who performed relaxation and flexibility exercises reported the same results. At the end of a year, more than half of the exercise group was no longer diagnosed with fibromyalgia compared to only 34% of the relaxation group.

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In general, graded exercise involves:

• Exercises such as walking, swimming, and using equipment like treadmills or stationary bikes. Swimming and water therapy, which eliminate weight-bearing, appear to be excellent choices for getting started. In one 2002 study, patients who engaged in water exercise therapy for six months still reported improvements in symptoms and functioning two years after they had completed the program.
• A very gradual incremental program of activity, beginning with mild exercise and building over time, is important to help patients comply with exercise. For example, in one successful exercise study, patients started with two weekly sessions that lasted for only six minutes each. By week 12, they were performing exercises that lasted 25 minutes each with sufficient intensity to produce some sweating while still allowing them to talk comfortably.
• Patients should do stretching exercises before engaging in physical activity. A daily stretching routine can also help relax tense muscles and prevent muscle soreness.