Exercise Helps In Fibromyalgia Despite Initial Pain

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Exercise Helps In Fibromyalgia Despite Initial Pain

A DGReview of : " Prescribed exercise in people with fibromyalgia: parallel

group randomised controlled trial. "

British Medical Journal (BMJ)

07/25/2002

By Harvey McConnell

A series of controlled graded aerobic exercise is a simple, cheap, and

effective treatment for patients with fibromyalgia.

A major problem at the beginning of an exercise program is convincing

patients it will work because they suffer initial increases in pain and

stiffness immediately after exercise. This may convince many patients at the

beginning that exercise will worsen their condition, warns Dr Selwyn

s and colleagues at the Department of Rheumatology at Poole Hospital,

Poole, Dorset, England.

Conventional medical treatment of fibromyalgia with analgesics,

non-steroidal anti-inflammatory drugs, and antidepressants is relatively

ineffective, the clinicians said. Several randomized controlled trials of

exercise therapy in fibromyalgia produced generally positive results, but

were under-powered, excluded many cases, and were supervised in hospitals by

highly experienced healthcare professionals.

One hundred and thirty two men and women with fibromyalgia, selected from an

initial population of 7,806 patients attending the hospital rheumatology

clinic, were enrolled over a one year period into a randomized controlled

trial. The patients were randomly assigned to either aerobic exercise

classes or relaxation classes, twice weekly for 12 weeks. Classes were

carried out by personal trainers with no special experience in providing

exercise for people with ill health.

The clinicians then gauged results based on the men and women who reported

on their improvement, plus tender point count, impact of condition measured

by fibromyalgia impact questionnaire, and short form McGill pain

questionnaire.

The exercise program, when compared with the relaxation program, led to

significantly more men and women rating themselves as much, or very much,

better at three months. These benefits were maintained, or even improved in

some patients, when they were assessed a year later, especially the fall in

tender point counts.

The researchers said exercise treatment has limitations, especially with

compliance by the men and women when they suffer pain after beginning the

exercise program. " Future strategies to increase the efficacy of exercise as

an intervention should confront the issue of compliance, " they conclude.

BMJ 2002; 325:185-187.