Fibromyalgia Exercise, One Step at a Time

Medically Reviewed by David T. Derrer, MD on October 18, 2013
5 min read

When Lynne Matallana was first diagnosed with fibromyalgia, she spent most of her time in bed. Then her doctor suggested she get some exercise.

“I knew I’d have to start really slowly, so I started exercising while I was still in bed,” says Matallana, president and founder of the National Fibromyalgia Association. “I’d do some stretching for about half an hour and then take a rest.”

Gradually she worked up to walking to the mailbox and back, and then to more steady exercise on a treadmill. Today, she credits exercise with playing a big role in improving her fibromyalgia pain.

This step-by-step plan can get you started on your own exercise program for fibromyalgia.

“Exercise is one of the most effective treatments for fibromyalgia,” says Daniel Clauw, MD, professor of anesthesiology and medicine at the University of Michigan. “It benefits all of the symptoms of fibromyalgia, including pain, fatigue, and sleep problems.”

Exercise can help maintain bone mass, improve balance, reduce stress, and increase strength. Getting regular exercise can also help control your weight, which is important to reducing the pain of fibromyalgia.

“Moving your body may be the last thing you feel like doing, but you have to believe that it really does help,” Matallana says. “It’s hard at first, but it does get easier.”

Whether you’re used to running marathons or you’ve never exercised, the key is to start with something small and gradually increase your activity level. Like Matallana, many of those with fibromyalgia need to start very slowly.

Clauw sometimes tells his patient to think of exercise like taking a medication that starts out with a low dose and increases over time. For example, you can start walking just five minutes a day for a week and then add a minute each week until you’re up to 20 to 30 minutes a day. “It might take 15 weeks to reach that point, but that’s OK,” Clauw says.

“For people who aren’t used to exercising, we focus on getting them to be more active and don’t even call it exercise,” he adds. “Instead, we talk with them about being more active, such as walking a bit more or climbing a flight of stairs.”

Moving your body at all may be difficult at first, but as you continue, you should notice that the activity gets easier.

A 2010 study published in Arthritis Research & Therapy found that regular daily activities, such as taking the stairs, gardening, or doing chores, can help reduce pain and improve daily functioning for those with fibromyalgia. “This study shows us that every bit of activity is beneficial for fibromyalgia pain,” Clauw says. “It doesn’t need to be a formal exercise program.”

If you were very active before fibromyalgia, you may need to learn a different approach to exercise now. Many people try to do too much too soon and then feel frustrated when their symptoms flare up.

“For those who were used to being athletic, we often need to teach them to listen to their body and learn to take it more slowly than they may be used to,” says Kim D. Jones, PhD, associate professor at the Oregon Health and Science University School of Nursing in Portland.

Eventually, you will learn what level of exercise is good for you and how much is too much.

“To get the most benefit from exercise, you really need to do it on a daily or almost daily basis,” Clauw says. “So for many people, the best options may be walking or using exercise equipment, since these are activities that are easily accessible most days of the year.”

Exercising in a warm pool is another good way to start being active. Warm water has a soothing effect on muscles and joints and may make exercise less painful. But even if you start in a pool, it’s still a good idea to work towards a ground-based workout.

“I’m not a big fan of the continued use of warm water exercise because most people don’t have access to a heated pool every day,” Clauw says.

Cycling, running, yoga, strength training, and low-impact exercise classes are just a few other ways to get exercise and help ease the symptoms of fibromyalgia.

“The most important thing is to find some kind of exercise you enjoy,” Matallana says. “Take a walk, visit your neighbor, walk the dog. If you can find a friend or family member to exercise with you, that can be helpful, too.”

Whether you’re walking or participating in an exercise class, these exercise tips can help prevent injury or pain:

  • Exercise at the time of day that you feel best. For many people with fibromyalgia, this is between 10 a.m. and 3 p.m. But your best time may be different.
  • Stretch. This can help warm up muscles and minimize pain after exercise. You can stretch while lying down, standing, or sitting in a chair. Some people may find it helpful to stretch in a warm bath or shower.
  • Take small steps. When walking, try not to swing your arms too much or take big steps. Walk on flat, even surfaces to reduce your risk of falling.
  • Ease into strength training. For strengthening exercises, consider using elastic bands instead of weights and start with a single set of repetitions.
  • Pace yourself. When doing stretching or strengthening exercises, alternate sides often and take a short rest between repetitions.
  • Take breaks. Again, listen to your body. “When I was first starting, I’d rest after just a few minutes of exercise,” Matallana says. “Don’t be afraid to go as slowly as you need to.”
  • Pamper yourself afterward. When you’re finished exercising, take a hot shower or bath.

Although exercise can improve the symptoms of fibromyalgia, the effects are not always immediate. “Exercise is really the best long-term treatment for the pain and fatigue of fibromyalgia,” Jones says. “But it can take up to six months before you notice a change in your symptoms.”

“You definitely need to be patient and work slowly,” Matallana says. “It may seem like it’s taking forever to reach your goals. But as you gradually increase your movement, you will feel better and notice a decrease in your symptoms. In my experience, exercise is the No. 1 thing to start you on your journey to wellness.”