Pain Relief for Fibro
Over the last few years many pain management programs designed for those with fibromyalgia have begun to incorporate physical therapy, based on the knowledge that regular exercise has significant benefits for many causes of pain, as well as being great for general health. In a Cochrane review of exercise interventions for fibromyalgia, the evidence supports the idea that resistance training can reduce pain and improve a range of parameters for women with fibromyalgia. The review also noted that aerobic exercise helps reduce fibromyalgia pain, offering hope of a non-pharmacological therapy for neck pain from the condition.
Reluctance to Exercise with Fibromyalgia
Unfortunately, this latest review is based on only a few studies with low-quality evidence and so the findings are far from universally applicable and individuals should exercise caution and, as always, discuss any changes in their exercise regime with their physician first. Many physicians are reluctant to advise patients with fibromyalgia to exercise as it seems counterintuitive to apply further physical strain to someone already experiencing fatigue and muscle aches and pains.
Less Pain and Tenderness, Improved Muscle Strength and Function
The latest research found that moderate- to high-intensity resistance training improved levels of pain, tenderness, and muscle strength, as well as a range of functional markers in women with fibromyalgia. They also found that aerobic exercise was even better than resistance training in terms of pain relief for the women in the study. A combination of the two is often recommended to help reduce the risk of diabetes and complications, as well as to improve overall health and well-being.
Those taking part in the studies under review were engaging in the exercise under supervision and the authors emphasised the importance of this as the women started off slowly and gradually increased the level of resistance. Starting out hard and fast can lead to injury and increased pain and fatigue and so anyone considering the use of resistance training for fibromyalgia pain relief should remain cautious and pay attention to any severe pain.
This latest review looked at five key studies, with around 200 women with fibromyalgia who either engaged in resistance training or acted as controls. The trials lasted up to 21 weeks in some cases, and just 8 weeks in others and compared moderate- to high-intensity resistance training to with a control group, progressive resistance training with aerobic training, and low-intensity resistance training with flexibility exercise.
Despite the small number of participants in the research, there was a statistically significant difference that showed resistance training to be of most benefit for multidimensional function, muscle strength, self-reported physical function, and number of tender points. Pain reductions were most significant for those engaging in aerobic exercise but the differences between multidimensional function, tenderness, and self-reported physical function didn’t vary significantly between resistance exercise and aerobic exercise. Resistance training was significantly more effective than flexibility exercise for multidimensional function and pain but not for number of tender points or muscle strength.
No Adverse Effects
Resistance training, either using free weights of the person’s own body weight, can help to improve bone density and strength (reducing the risk of osteoporosis), and improve regulation of blood sugar and markers for inflammation. Importantly, no serious adverse effects were reported during the studies and the women with fibromyalgia fared well in terms of engaging in resistance training.
How Exercise Helps with Fibromyalgia Pain Relief
It may be that part of the positive effect is due to improved perception of ability and functional capacity, just as has been seen with other patients with chronic pain. When we fear that physical activity or movement will lead to pain increasing or arising then that can have a seriously detrimental effect on quality of life. Supervised resistance training and aerobic activity may have allowed these women with fibromyalgia to rediscover their capacity for physical activity and reduced their fear of such pain.
Angela J Busch, Sandra C Webber, Rachel S Richards, Julia Bidonde, Candice L Schachter, Laurel A Schafer, Adrienne Danyliw, Anuradha Sawant, Vanina Dal Bello-Haas, Tamara Rader, Tom J Overend, Resistance exercise training for fibromyalgia, Cochrane Database Syst Rev. Published online December 20, 2013.