Dr James Alexander, PhD- Psychologist

Often, the last thing people with fibromyalgia (widespread musculoskeletal pain accompanied by sleep disturbance and fatigue) want to do is exercise. However, research conducted with people suffering from this chronic pain condition has recently demonstrated that regular levels of moderate exercise can help to reduce the pain and other symptoms over time. Clearly, we are designed for regular and vigorous movement. Chronic pain will usually result in a reluctance to exercise, with a fear of causing more structural damage in the body. This is based on the mistaken assumption, often promoted by the "pain industry", that chronic pain results from damage to the structures of the body, eg. the spine. But, research does not support this contention. Most of the structural pathologies which are found to exist in the chronic pain population are also found to exist in the pain-free population. In addition, there are many people in serious pain that have no structural pathologies at all- yet their pain is entirely real. The only sensible conclusion to arrive at is that for the majority of people in chronic pain (including fibromyalgia) there is no one-to-one relationship between structural pathology in the body and the experience of chronic pain.

Due to the (mostly unwarranted) fear of exacerbating structural pathology, most people in chronic pain are reluctant to engage in exercise. The research shown below demonstrates that people suffering from fibromyalgia experience no increase in pain as a result of exercise, and in fact often report a decrease in pain over the time they have been exercising. An initial increase in pain that can accompany exercise when it has not been done for a long time is often enough to frighten chronic pain sufferers. The research demonstrates that this fear is largely unwarranted, and if people are able to persist with moderate exercise, they will often begin to experience a decrease in their pain and other related symptoms.

The key to exercise when you are in pain is to start with where you are at in terms of fitness- don't expect to run a marathon. Find a form of exercise which is at least partly pleasant (avoid types which are distinctly unpleasant to you), e.g walking. If you can find an exercise mate to do it with you, even better- you can encourage and support each other. Use a 'pacing' approach rather than boom or bust (excessive exercise one day, followed by many days of suffering, discouragement and inertia). Work out how many minutes of the exercise you can do, even on the worst pain day. For the next week, do this amount regardless of how you feel. The following week, re-evaluate what you can do even on the worst day, and then do this for all of that week. Continue with this approach over the ensuing weeks until it simply becomes a life style habit to use your body. This is likely to result in an eventual decrease in pain, as well as a decrease in fear of re-injury. An exercise physiologist may be able to help you work out a suitable exercise program in consideration of your limitations.

http://www.sciencedaily.com/releases/2013/05/130502115525.htm#.UYREQLmCjMQ.email