Aerobic Exercise May Reduce Pain and Improve Function in Patients with Fibromyalgia

Fibromyalgiais a complex, chronic, and disabling disorder that is marked by widespread pain. People with fibromyalgia have difficulty sleeping and experience fatigue and weakness. This can cause problems with concentration and thought or memory. There is no cure, so treatment focuses on relieving or controlling symptoms. Methods include physical therapy, heated pool treatments, cognitive behavioral therapy, and alternative treatment methods like acupuncture.

Researchers wanted to evaluate the benefits and harms of aerobic exercise training for adults with fibromyalgia. Aerobic exercise is exercise that strengthens the heart and lungs, such as running, swimming, or cycling. This study, published in The Cochrane Database of Systematic Reviews, found that aerobic exercise may reduce pain and improve physical function in people with fibromyalgia.

About the study

The systematic review of 13 randomized controlled trials included 839 adults with fibromyalgia. The treatment duration ranged from 6-24 weeks. Participants were randomized to an aerobic exercise group or a control group that received standard treatment, wait list, or usual daily activities. The aerobic exercise group participated in activities such as walking, cycling, running, and low-impact aerobics or aquatic exercise. Treatment frequency was 2-3 sessions per week that lasted about 35 minutes per session.

Compared to the control group, the supervised aerobic activity group had:

  • Reduced pain intensity (6 trials with 351 participants)
  • Improved physical function (3 trials with 246 participants)
  • Improved health related quality of life based on a questionnaire (5 trials with 372 participants)
  • Reduced stiffness (1 trial with 143 participants)

The study did not find significant improvements in fatigue in an analysis of 4 trials with 286 participants.

A long-term analyses found that supervised exercise improved pain, but did not improve health related quality of life or fatigue compared to the control group in an analysis of 2-3 trails with 100-134 participants.

How Does this Affect You?

A systematic review combines a number of smaller trials to create a larger pool of participants. The larger the pool of participants, the more reliable the outcomes are. However, the quality of the smaller trials will also affect the reliability of the outcomes. The studies included here were small trials that had some quality issues. The participants knew which group they were in, which could have affected how the participant reacted to treatments, especially given that major outcome measures were self-reported. The studies also used differing exercise types, so we are unclear about effect of each type.

Most of the studies did not measure adverse events, so we don't know if there are any risks associated with exercise and fibromyalgia patients. However, exercise has well known overall health benefits. Aim for a regular exercise program that includes aerobic activity, strength training, and flexibility exercises. Gentle exercises like walking, biking, and swimming may reduce stress on painful areas. Talk to your doctor to make sure it is safe for you to start exercising and which type of exercise might be best for you.

Resources

American College of Rheumatology
http://www.rheumatology.org
The American Fibromyalgia Syndrome Association
http://www.afsafund.org

Sources:

Bidonde J, Busch AJ, et al. Aerobic exercise training for adults with fibromyalgia. Cochrane Database Syst Rev. 2017 Jun 21;6:CD012700.
Fibromyalgia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116339/Fibromyalgia. Updated February 5, 2018. Accessed February 26, 2018.
Last reviewed February 2018 by EBSCO Medical Review Board

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