A daily, gentle, low-impact aerobic exercise is of central importance in the treatment of fibromyalgia and other types of chronic pain syndromes. Exercise prompts your body to release special chemicals, called endorphins, that actually block pain signals from reaching your brain. These chemicals also help alleviate anxiety and depression, conditions that can make your pain more difficult to control. Endorphins are the body's natural pain-relieving chemicals that in many cases are more powerful than morphine. Regular exercise also improves your sleep and gives you more energy to cope with your pain. It can help you lose weight, which will reduce the stress on your joints. Don't be discouraged, however, if you don't lose weight. Exercise can increase weight by adding new muscle. Researchers have found that an overweight person who is fit is better off than a thin person who doesn't exercise.
Deconditioned muscles are more prone to microtrauma and can lead to further dysfunctional behavioral problems. Many hormones are supposed to be released during exercise and daily physical activities, but in patients with fibromyalgia, these hormonal systems are dysfunctional. A properly designed exercise program may help you minimize the impact of these abnormalities and improve your bodyís ability to function. A common misconception is that exercises increases pain and that rest is better for fibromyalgia sufferers. But the opposite is true. Too much rest will lead to deconditioning that can lead to further problems that may worsen your pain. Excessive rest will cause you to lose muscle tone and strength, increase your risk of high blood pressure, high cholesterol and diabetes, and put your at higher risk for heart attack and stroke. Leading a lifestyle without enough exercise will worsen your sleep and fatigue symptoms, and cause you increased stress, anxiety and pain.
Although
many health care providers may just tell you to exercise and you will improve your
condition this is not necessarily true. There are many inappropriate exercise
movements that may worsen your pain and exercise alone is not a treatment for
fibromyalgia. However, it is an excellent way to help you cope with your
chronic, fatiguing illness while staying active and functional. All
fibromyalgia patients need to have a home program with muscle stretching,
strengthening, and aerobic conditioning. Engaging in an appropriate exercise
program will provide you with the following benefits:
·
Increased energy.
·
Improved sleep.
·
Promotes weight loss, thereby reducing stress on your joints.
·
Increases bone mass, reducing your risk of fracture or osteoporosis.
·
Relieves stress.
·
Increases natural endorphin production by your body, thereby alleviating
some of the anxiety, depression and pain associated with fibromyalgia.
A
regular exercise program designed to improve physical fitness should include:
·
Stretching.
·
Strength Training.
·
Aerobic activities.
It is
also important to remember that exercise accompanied with some of the other
possible treatments for fibromyalgia will work better than exercise alone.
Recent studies have indicated that exercise combined with cognitive behaviour
therapy or meditation, is more effective than exercise alone.
Stretching
improves your flexibility, ensuring that your joints can move through a full
range of motion. This will allow you to perform the regular activities of daily
living (ADLs) easier and more efficiently. Also, by improving your flexibility,
you prevent your muscles, tendons and ligaments from shortening and weakening,
thereby reducing your risk for injury and pain. Do gentle stretching every day
to keep muscles loose and out of their tight and contracted state. With
stretching, go to the point where you feel a tightness or resistance ñ never stretch
to the point of pain.
Your health care provider may engage you in a type of stretching known as
"myofascial spray and stretch." This consists of an application of a
vapocoolant spray, such as ethyl chloride over the painful muscle. A fine
stream of the spray is aimed toward the skin directly overlying the muscle with
the tender point. This is followed by a progressively increasing stretch of the
muscle.
This
allows you to improve the overall strength of your muscles. Developing stronger
muscles will allow you to perform the activities of daily living (ADLs) ñ such
as bringing in the groceries ñ with more ease, thereby reducing your fatigue.
Having stronger muscles also means an increase in your lean body mass and a
decrease in body fat. This has the effect of helping you burn more calories
which will help in weight loss. Decreasing your weight will have positive
effects on your joints and joint pain.
Aerobic
exercises such as jogging or bicycling improve the way your heart, lungs and
muscles operate. The net effect of this is a decreased heart rate, decreased
blood pressure, decreased cholesterol level, and a stronger heart. By adding
aerobic activities of 30 minutes duration, three days a week, you will reduce
your risk for heart attacks, strokes, and other cardiovascular diseases. You
will also find that exercising just a few times a will improve the amount of
energy you have during the rest of the week, preventing you from becoming easily
fatigued. Below are a few types of aerobic exercise you may want to try:
· Walking. You may want to start your slowly by walking for 5 minutes the first day. The following day you should add a minute to your walk. Keep adding 1 or 2 minutes a day until you are walking for 60 minutes a day. When you reach this point, try to walk for one hour a day, 3 to 4 days a week. If you find it very difficult or uncomfortable to stay at one hour walks, then you can try going back to a time that is a little more comfortable until you feel ready to start increasing your times again.
· Jogging. After you have reached a point where you are very comfortable with walking for one hour, 3 to 4 times a week you can start alternating your walks with slow jogs. You can try walking for 2 blocks, then jog for 1 block, walk for 2 blocks, jog for 1 block etc. After you are comfortable with this you can try walking for 1 block, jog for 2 blocks, walk for 1 block jog for 2 blocks etc. Continue to increase the number of blocks you jog before you have to walk for 1 block. Do this until you can jog the entire distance. After this point, you can begin to extend the distance that you jog or speed up your jog.
· Bicycling. Whether you bicycle outdoors or you prefer exercising indoors on stationary bicycles (exercise bikes), bicycling is a very good anaerobic exercise. As with the other types of exercises, begin slowly and work your way up to a goal of bicycling for 60 minutes.
· Water exercise. Aerobic water exercise may be best tolerated because it eliminates any weight-bearing, but it may be hard for you to get to a pool every day. Water temperature is important. You should avoid any situations with extremely warm or cold water as this may make your symptoms worse. Water exercise may be particularly useful for you if you canít tolerate anything else. Once your stamina improves you should add another form of exercise on the days you don’t swim.
Your
program should incorporate all of these activities. Try stretching in the
mornings, and before and after any physical activity. Low-impact aerobic
exercises such as walking, swimming, and stationary bicycling can be very
helpful. Make sure not to overdo it. Overdoing exercise or even rigorous daily
tasks will actually make your muscles contract, the opposite of what you want
to accomplish. You may need to begin at a very low level of exercise such as 5
minutes every other day. You should continue to increase the length and
frequency of exercise until you are exercising for at least 20 to 60 minutes 4
times a week. At first you may experience a little pain and soreness following
a workout. Some muscle soreness is normal when youíre
starting to exercise, but sharp pain may be a sign that you have overworked
your muscles. As time progresses, you will find that the pain following an
exercise workout will lessen, as will your fibromyalgia symptoms.
Remember,
the type of exercise that you choose is up to you. The most important thing is
that you start exercising and keep doing it. Unfortunately, maintenance of
exercise regimens tends to be poor in patients with fibromyalgia. Without a
consistent exercise program you will not see much improvement in your symptoms.
Staying compliant with your exercise routine will not only help relieve your
pain, it will also make you feel better by giving you back some control over
your own care and well-being.
Even if you recognize all the benefits of exercise, you may have trouble staying motivated. Many people find that their energy levels and moods improve after they become more physically fit. Here are some other suggestions for staying on track.
·
Set goals. Make your goals specific, measurable and realistic. It's easy to
get frustrated and give up on goals that are too ambitious. The key is to set
goals that are specific,
measurable,
attainable,
realistic
and tractable
(SMART):
o
Specific. State exactly what you want to achieve, how you're going to do it
and when you want to achieve it. To begin with, set goals that you can achieve
within a week to a month. It's easy to give up on goals that take too long to
reach. If you have a big goal, break it down into a series of smaller weekly or
daily goals. After you achieve one of the smaller goals, move on to the next.
o
Measurable. A goal doesn't do you any good if there's no way of telling
whether you've achieved it. "I want to feel better" isn't a very good
goal because it's not specific and it's difficult to measure. "I want to
work 8 hours each day" is a better goal because it's specific and
measurable.
o
Attainable. Ask yourself whether the goal is within reasonable reach. For
instance, completing a marathon may not be an achievable goal if you've never
run before. However, completing a 5K run may be attainable.
o
Realistic. Is the goal realistic for you? The purpose of a goal is to shift
your focus from your pain to your future. But you can't ignore your
limitations. Your goals need to be within your capabilities. If you've suffered
a serious back injury, a goal of returning to work as a bricklayer may not be
realistic. Instead, your goal might be to find a sales job in a related field.
Or you might decide to go back to school for training in a new field.
o
Tractable. Being able to track your progress encourages you to keep going
and reach your goal. Look for ways to chart your improvements.
Muscle soreness after exercise is normal. It means you've stimulated your muscles to grow stronger. You can ease this type of pain with stretches, ice and continued moderate exercise. However, if your chronic pain worsens during exercise, that's an entirely different situation. The rule of thumb is: “It is OK to hurt after exercising, but you should avoid hurting while you exercise.”