Exercise and Fibromyalgia: Impact on Symptoms and Quality of Life
Fibromyalgia is a common musculoskeletal disorder usually affecting women age 40-75 years old.1 The American College of Rheumatology (ACR) describes it as “a chronic, painful, non-inflammatory syndrome involving muscles rather than joints” 1 With the many symptoms associated with this condition; sleep disorders, deep burning ache, mood disorders, and fatigue, their quality of life can be affected, and many times diminished. 2 The cause of fibromyalgia is mainly unknown, with postulations being made of it having a genetic, neuroendocrine, neurologic, and/or a psychological origin.3
The ACR has given guidelines of the criteria they use to establish a diagnosis of fibromyalgia. First, there must be a history of widespread pain that has lasted at least 3 months. Secondly, there are 18 tender points associated with fibromyalgia; 11 of those must have pain on palpation to be considered diagnosable. 2 As you can see, these symptoms can often be misinterpreted for another condition, as many diseases can demonstrate these characteristics it is not solely specific to fibromyalgia. This in turn has made it difficult to diagnose and accurately treat fibromyalgia. 4
As physical therapists, we wonder what our contribution can be to the treatment of fibromyalgia (FM). One of the interventions that we commonly use is therapeutic exercise. It is important to determine the correct dosage of intensity, frequency, and duration, to elicit a therapeutic effect. Unfortunately, there is not a broad spectrum of research currently that delineates what that dosage is for FM patients. However, what we can do is look at the effect exercise has in general of treating people with a variety of conditions, and apply that specifically to our patient population. Exercise tends to elicit a physiological response that impacts pain perception; both chronic and acute. 5 In addition it exhibits an analgesic effect which can be useful in decreasing pain levels, and in improving the quality of life of patients with FM. 6
A study done by Gordon, et al., set out to determine if exercise intensity, frequency, and duration could predict the quality of life, and impact the symptoms in those with FM. The conclusion was that while exercise could not predict quality of life, it did show a correlation in improved reports in certain aspects of quality of life in patients that exercised with moderate to vigorous intensity.6 This study had a small sample size, so further research is needed to gain a more precise and detailed summary of the correct dosage necessary to treat patients with FM. 7
As physical therapists, we play a role in the multidisciplinary approach to treating not only those with fibromyalgia, but also those with a myriad of other conditions. As more research is conducted, with our training, we should effectively use therapeutic exercise to treat patients and assist in pain reduction, to improve quality of life and decrease symptoms associated with FM.
- Peterson EL. Fibromyalgia– Management of a misunderstood disorder. J Am Acad Nurse Pract. 2007;19(7):341-8.
- Wierwille L. Fibromyalgia: Diagnosing and managing a complex syndrome. Journal of
the American Academy of Nurse Practitioners. 2012; 24: 184-192.
- Jahan F, Nanji K, Qidwai W, Qasim R. Fibromyalgia syndrome: an overview of
pathophysiology, diagnosis and management. Oman Med J. 2012;27(3):192-5.
- Kosek E, Meeus M, Nijs J, Oosterwijck J. Dysfunctional Endogenous Analgesia
During Exercise in Patients with Chronic Pain: To Exercise or Not to Exercise?. Pain
Physician. 2012; 10: 205-213
- Bellanto E. Marini E, Castoldi F, et al. Fibromyalgia Syndrome: Etiology
Pathogenesis, Diagnosis, and Treatment. Pain Research and Treatment 2012;2012;1-17
- Kolyton K. Analgesia Following Exercise A Review. Sports Medicine. 2000; 2: 85-98.
- Gordon, Peters, Santos, Schact, Does Exercise Duration, Intensity, and Frequency Predict Health
Related Quality of Life or Impact of Symptoms in Women with
Lydia Peters, PT, DPT
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