Exercise As ‘Medication’ For Fibromyalgia

Fibromyalgia is a real and stubborn medical problem that doesn’t usually respond very well to medication. The right kind, the right amount, and the right intensity of exercise, however, can reduce pain.

Most people who have fibromyalgia go through a long process just to begin to get treatment. Fibromyalgia most often presents itself in young or middle aged women, although anyone of any age can develop the disease. Doctors are never especially eager to diagnose fibromyalgia.

The guidelines require that the pain has to be widespread and continuous for at least three months. Usually that’s three months as reported to the doctor, not three months as noticed by the patient. In the West, fibromyalgia is a diagnosis of exclusion, which means a long list of other diseases has to be ruled out before fibromyalgia is ruled in.

Getting Your Doctor To Believe In Your Pain

Fibromyalgia is diagnosed in terms of pain at any of 18 paired pressure points or three single pressure points. The problem for many patients is that they feel pain no matter where the doctor presses against with a device known as a pressure algometer or dolorimeter (pain meter). Some doctors press on the skin where there isn’t a diagnostic point with the expectation that someone who is “faking it” will complain in pain.

The fact is, just because you have pain in places that aren’t usually linked to fibromyalgia doesn’t mean you don’t really have the disease.

‘I’ll Just Take One Of Each’ At The Pharmacy

Pain specialists try offer chronic pain relief with muscle relaxants, antidepressants, antianxiety agents, alpha-2 agonists (which activate an inhibitory nerve that slows down heart rate and reduces sensitivity of muscles to pain triggers), and a variety of pain relievers. The problem with medication for fibromyalgia is that starting any new medication may lower the pain threshold, and stopping any old medication can also lower the pain threshold, and changing dosage can make pressure points more sensitive, too. It can take a long time just to establish credibility with your doctor, and even longer, sometimes many years, to hit on a combination of medication and lifestyle changes that actually work. Exercise, however, sometimes provides pain relief relatively quickly.

What About Exercise?

Dr Laura Ellingson,¬†an assistant professor of kinesiology at Iowa State University in the USA, recently reported a clinical study that found that exercise could “temporarily improve centrally mediated pain modulation.” In other words, getting some exercise helps the brain be less responsive to the triggers that cause pain.
Ellingson and her collaborators recruited 12 women to work out on a stationary bicycle for 25 minutes, and then to have a functional MRI of their brains. The women were then told to go home and avoid exercise, resting as much as possible, for a week. At the end of the week, the women were given a second MRI to look for changes in their pain centers.
The researchers found that the exercise session resulted in greater activity in a part of the brain known as the anterior insula or the insular cortex. This part of the brain is involved in activities ranging from bowel movement and sex to making complex decisions about what to do in the world. It is a key part of the brain in creating consciousness. When this part of the brain is active, it “wakes up” to sensations other than pain, pain, and more pain.

How To Treat Fibromyalgia: Training Your Brain To Feel Less Pain

Dr Ellingson believes regular, mild exercise may train the brain to be less responsive to fibromyalgia triggers and more in tune to the rest of the human experience. People who have fibromyalgia who just workout for 20 to 30 minutes a few times a week may activate the insular cortex often enough that their symptoms become less severe.
These findings, of course, are hardly unique. There have been over 800 studies of the use of exercise in reducing fibromyalgia pain. Some of the key findings of research that relate to ordinary people who just want to have less pain without trying yet another drug include:
  • “Isometric yoga,” holding yoga poses to stretch and warm muscles, sometimes provides pain relief when medications don’t work. A 20-minute session, preferably with an instructor, usually is enough to make a difference. It isn’t necessary to do asanas (positions) that cause pain to get benefits from this form of exercise.
  • Doing qigong every day for six to eight weeks can result in reductions in pain that can last for four to six months even if the practice is discontinued. With qigong, the studies show that the more you practice, the less you hurt.
  • Exercise often eases depression. One study found that many people who have fibromyalgia also have obsessive-compulsive disorder or anxiety disorders, and that exercise greatly reduces the symptoms of those conditions, too.
  • How tired you feel after you work out, if you have fibromyalgia, is not necessarily related to how hard you work out. Just going for a walk can be exhausting. Generally, exercise to the point of exhaustion, of simply not being able to lift a heavier weight or not being able to continue walking, running, or swimming, does not help with fibromyalgia pain. Exercising only to a point less than exhaustion is what is needed for pain relief. However, expanding aerobic capacity or building new muscle still requires a hard workout. Most people who have fibromyalgia don’t have a problemw ith choosing to work out less.
  • Exercise can change the way selective serotonin reuptake inhibitors (SSRI antidepressants, for example, Prozac) work. This effect may be unpredictable.
  • In fibromyalgia, exercise may temporarily reduce the potency of certain parts of the immune system. The immune system is less able to attack bacteria, for up to 24 hours, after a workout. This means it is important to wash hands after using shared equipment and more important to dry out carefully after using the locker room.
  • Weight-lifting and strength-building exercises can improve quality of life, and build self-esteem, but they don’t offer many benefits for pain management. The fact that you have fibromyalgia changes the way your muscles are able to build new tissue when you work out. Protein supplements and workout drinks simply don’t have the same effect as they do in people who don’t have your condition. They are more likely to be turned into fat (although they don’t go “straight to fat”) than to muscle, but that doesn’t mean you should not get all the protein and carbohydrate you regularly need when you are working out to build muscle strength.

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