Fibromyalgia and exercise

When you are experiencing chronic pain and the fatigued feeling of fibromyalgia, it doesn’t seem like muscle flexibility or physical exercise will be a major priority. The obvious path is to get some rest and relaxation. However, both flexibility and exercise will be important for your quality of life generally, and specifically for management of your pain. It will be wise to start seeing a physical therapist to get medical supervision while you pursue this.

There are two main types of personality when it comes to exercise for fibromyalgia. There are those that were very active to begin with, and they see the syndrome has just been an obstacle to their continued activity. They have little difficulty getting motivated to be active. What they tend to have a problem with, is overdoing it when they feel well so that they trigger a flare-up of symptoms and then make themselves unable to keep going.

Then there are those who are only active reluctantly. When it is suggested that they need to get some exercise for their fibromyalgia, they are very hesitant about it. It seems fair to say that there would be quite a few of us in this situation, since, as previously pointed out, getting some exercise when you are in pain seems counterintuitive. However, these folks are unlikely to overdo it and cause themselves injury. Rather, it can be hard to motivate them to try exercise in the first place.

Regardless, exercise in moderate amounts is helpful for fibromyalgia. Also, it is clear that the presence of a therapist can be helpful, since they will control the over-achievers, and motivate the reluctant exercisers.

Physical therapy

A gentle regime of physical therapy can help a patient with fibromyalgia through both active and passive treatment methods. Passive methods are essentially treatments where the patient is the recipient of therapy, like massage or heat therapy. Active measures mean that the patient is the main participant, like in exercise or stretching. The physical therapist will probably use different techniques in combination to relieve your pain and other symptoms.

fibromyalgia and massage

Passive Treatments for Fibromyalgia

Deep tissue massage

A specialist uses deep pressure to relieve tension and decrease muscle spasms. Deep tissue massage often uses many of the same strokes as regular massage, but is much more intense and the pressure applied is greater. The intention is to massage all the layers of the body’s soft tissue to relax and relieve pain.

Heat or thermo-therapy

The application of heat in the affected area. This will increase blood flow and relax muscles. Either a dry heat such as a heating pad, or a moist heat, using a wet cloth, for example, will be used.


This is the use of water to relieve and treat pain. It uses both warm and cold water, though for chronic pain it will generally be warm water used. You may sit in a warm bath to relieve pain and muscle stiffness.

Transcutaneous electrical nerve stimulation (TENS)

This is the use of an electrical current to stimulate nervous response for therapeutic purposes. This treatment decreases fibromyalgia-related pain by blocking pain signals from reaching your spinal cord. It also reduces muscle spasms and triggers the release of endorphins.


This uses sound waves emitted from a hand held wand. The waves penetrate one to two inches into the soft tissue. It is often used in combination with TENS as a more effective way to decrease pain, inflammation, stiffness, and muscle spasms.

Active Treatments for Fibromyalgia

Therapists will also prescribe some sort of active treatment. This generally means some sort of exercise. Exercises such as walking, strength training, and stretching activities will help improve your physical, emotional and social function.

As stated, active treatments almost always take the form of some sort of exercise, which we’ll talk about in the next section. Your physical therapist will design a physical therapy program to fit your needs which will often include a combination of passive and active treatments.


While it will be preferable to have either a doctor or therapist supervise your exercise regimen, this may not be a possibility, so we’ll quickly talk about the main forms of exercise that will be helpful for fibromyalgia.

Low-impact aerobic or endurance exercises

These types of exercise are gentle on the body, yet highly effective. Increases in your endurance from cardiovascular exercises just generally make life easier. They increase your ability to keep on keeping on. They strengthen and tone your muscles, increase coordination and, of course, increase your endurance. Finally, they also help with weight loss, which is always helpful for relieving joint pain.

If you are working with a therapist, they will generally outline your exercise regime. If you are going it alone, the decision about what kind of exercise you would like to do will be left up to you. You might try some traditional types of exercise like walking, cycling or swimming, or you might try some more exotic exercises. The more exotic exercises generally require a guide or instructor to perform properly. Some different kinds of exercises that may be tried include:

– Yoga—an ancient Indian form of exercise, derived from spiritual practices. The North American version focuses on the exercise aspect. Yoga serves both as a gentle cardiovascular exercise, but can also reduce stress and relieve muscle tension. It also helps with flexibility and range of motion. Practicing yoga for fibromyalgia when you are feeling tense or anxious may help you reduce stress and the risk of injury when you are on the job or at home.

– Tai chi—is essentially a very slow and precise version of martial arts. It involves the individual performing a series of flowing, graceful movements that can give you a good workout and stretching regimen. Like yoga, there are benefits to Tai Chi beyond the cardiovascular. People who participate in Tai chi have a greater sense of balance, can bend more easily and consequently have an easier time doing household tasks. Finally, the practice also improves core strength and improves that strength of your back.

– Pilates—focuses on breathing properly and working the core muscles. Again, not only will this form of exercise give you a low-impact cardio workout, but it will also help you develop core strength, which helps to support your spine.

Fibromyalgia and exercise

Core exercises

Core refers to your abdominal muscles, which can have a large impact on overall health. Core muscles support your back, and while it’s often forgotten, the fact is that back pain is lessened by having a strong stomach. Also, the area is called the core not only because it’s in the middle of your body, but also because it’s central to your body’s energy. A strong core supports everything you need your muscles to do.

Range-of-motion or stretching exercises

Exercises that increase flexibility. People suffering from fibromyalgia often have a restricted range of motion due to pain. These exercises involve putting a joint through its full range of motion or as far as it will go without causing pain. Flexibility is something that is definitely hampered by the general lack of activity and stretching that the syndrome causes. The lack of motion can cause immediate atrophy to start in the muscles around the joints. In turn, this atrophy will quickly result in an ongoing restriction of the joint’s range of motion.

Flexibility is also something that has a very direct impact on everyday quality of life, since it has a large effect on the performance of everyday tasks. It also has an impact on other forms of exercise, since almost all of these require a certain amount of flexibility to perform properly.

These are exercises you need to be careful with, since doing them incorrectly can exacerbate your issues. If you’re doing these under the supervision of a doctor or therapist, there won’t need to worry. They’ll explain and instruct you on how to do these exercises properly, and how to avoid more pain when you’re doing them.

Strengthening exercises

Strong, lean muscles handle pain better. These exercises help you to build strong muscles and tendons that you need to support your joints. Some studies show that strengthening exercises may improve fibromyalgia symptoms. Like stretching exercises, the strengthening exercises need to be done with caution to avoid hurting yourself. Again, though, if you are performing these exercises under medical supervision, it shouldn’t be a problem.

Whether you choose to pursue exercise through a physical therapist or on your own, it will definitely improve your quality of life and help control your pain.

Further Reading

“Physical Therapy for Fibromyalgia: Heat Therapy and Flexibility Exercises to Manage Fibromyalgia.” by Julie M. Gentile. Practical Pain Management.

“Fibromyalgia Health Center: Fibromyalgia and Exercise.” WebMD.

“Low impact exercise for fibromyalgia.” By Janice H. Hoffman. Fibromyalgia Information Foundation.

“Fibromyalgia Health Center: Fibromyalgia and Physical Therapy.” WebMD.

“Fibromyalgia: What Does the Research Literature Say About Exercise for Persons with Fibromyalgia?” National Center on Health, Physical Activity and Disability.