Exercise and fibromyalgia
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Fibromyalgia (FM) is a condition characterized by widespread musculoskeletal aches and pains, stiffness, fatigue and muscle spasms.
Many theories about what causes FM have been bandied about. These include: central neurotransmitter dysfunction, hormonal changes and others.
Information from the Arthritis Foundation and Fibromyalgia Network
Facts about Fibromyalgia
•Approximately, 10 to 11 million Americans, most often females, have symptoms characteristic of fibromyalgia .
•The median age at onset of FM is between 29 and 37, while the median age of medical presentation is between 34 and 53.
•Twenty percent of patients with rheumatoid arthritis also have FM, while both migraine and non-migraine headaches have been shown to occur in up to 58 percent of patients with FM.
•The most frequently reported symptoms of FM include: 1) generalized aches and pains, 2) multiple tender points, 3) stiffness, 4) reduced exercise endurance, 5) fatigue, 6) muscle spasms, and 7) paresthesias (burning or tingling of the skin).
•Irritable bowel and bladder, flu-like symptoms, Raynaud’s phenomenon, chronic fatigue syndrome, dysmenorrhea, mitral valve prolapse, temporomandibular joint syndrome, yeast infections, anxiety and clinical depression, and short term memory deficit, also have been associated with symptoms of FM.
Exercise is a building block in the treatment plan for FM. Many FM patients limit their physical activities because of the fear of feeling worse. The reality is that individuals with FM can't afford not to exercise.
Appropriate exercise slashes the downhill spiral of muscular and cardiovascular deconditioning and resulting loss of function that many individuals with FM experience. Deconditioning makes FM patients more susceptible to worsening of pain from physical activity.
Additionally, many FM patients have postural imbalances, tight muscles and range of motion issues, all of which place more strain on the body.
Chronic pain syndromes and their accompanying loss of function often lead to depression. Physical activity has been shown to be effective for improving mental and emotional outlook.
Finally, exercise increases endorphins and helps stabilize other neurotransmitter problems (serotonin and dopamine) permitting less pain to enter a patient’s life.
Prior to increasing physical activity level, it is a good idea to discuss plans with a knowledgeable physician. Because postural imbalance and tight, inflexible muscles are common in people with FM, every exercise session should begin and end with stretching (flexibility and range-of-motion) activities. Yoga and t'ai chi have been shown to be helpful for many.
Once a basic low impact cardio and stretching program have started, strength training can be added to the regime. Sessions should be two to three times a week and consist of light weights.
As mentioned earlier, aerobic exercise should be part of a patient's plan, but this should be low impact. Warm water is a good place to start for the FM patient who has never exercised.
Walking, while easy, may cause too much impact. An exercise cycle or elliptical trainer might be better. Other types of exercise (cycling, stair-stepping and other popular machines found in fitness facilities) are fine if proper instruction is given beforehand. Proper training in how to use the equipment is key.m Aerobic activities should be done a minimum of three times per week (daily when possible) for 20 to 60 minutes.
The key to exercise success for individuals with FM is consistency over time. During periods of flare up it is OK to back off or take a day off.
With stretching, strength training, and aerobic conditioning an FM patient can expect to see improvement in functional status.
Get more information about exercise and fibromyalgia and related issues as well as...
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