Seeking ways to reduce pain, increase energy and enhance quality of life are common goals of those living with fibromyalgia. Ideal complements to massage therapy, certain types of exercise are proven to reduce the pain associated with this condition. When working with fibromyalgia clients, incorporating exercise into your treatment plan (through teaching, suggesting or referring to an expert) will increase the effectiveness of all therapies being received.

About Fibromyalgia

Fibromyalgia is a medically recognized, chronic condition characterized by fatigue, widespread pain, stiffness, muscular aching and burning. Because there isn’t a specific diagnostic laboratory test for fibromyalgia, its diagnosis poses a challenge. Prior to receiving a diagnosis of fibromyalgia, many people endure several medical tests that are returned with normal results, such as blood tests and X-rays. Although these tests may rule out other conditions, such as rheumatoid arthritis, lupus and multiple sclerosis, they cannot confirm fibromyalgia.

The American College of Rheumatology has established general classification guidelines for fibromyalgia to help in the assessment of this condition. According to these guidelines, a diagnosis of fibromyalgia includes widespread aching pain for at least three months and a minimum of 11 out of 18 specified locations on the body that are abnormally tender under relatively mild, firm pressure.


While the cause of fibromyalgia is hotly debated, researchers are making steady progress in uncovering its mysteries. One such discovery is that a regular exercise program is of tremendous therapeutic value to a person suffering with fibromyalgia. One of the many possible theories explaining fibromyalgia is a lack of oxygen in muscle tissue. Whether deficient oxygen is a cause or effect of fibromyalgia, exercise is an excellent way to increase circulation and supply oxygen to our body’s cells.

In the March 2005 edition of Current Opinion in Rheumatology, Swedish researchers reported:

“Previous studies indicate that aerobic exercise performed at adequate intensity for an individual can improve function, symptoms, and well-being. A recent study of aerobic exercise showed that training in sedentary women with fibromyalgia using short bouts of exercise produces improvements in health outcomes. A study of aerobic walking resulted in improvements in physical function, symptoms, and distress. Two studies of low-intensity pool exercise reported a positive impact on fibromyalgia symptoms and distress. Two studies of qigong movement therapy were reported, one indicating improvements in symptoms and the other in movement harmony.”

Clients suffering with fibromyalgia may be dubious about physical exercise. Understanding why a person whose muscles already hurt and is physically exhausted would be suspicious of the benefits of working out, will help you communicate compassionately with them. While exercise is probably the last thing a person with fibromyalgia feels like doing, it is crucial for muscular health and pain relief. By increasing oxygenation of muscle tissue, exercise improves flexibility, range of motion, strength, endurance and energy levels.

When clients complain that prior attempts at exercise have been disappointing, explain that this is likely due to the increased pain that can occur from unaccustomed muscle use. In those with fibromyalgia, the brain misinterprets signals from the muscles, causing your body to act protectively as if the muscles were injured. Instead of its well-meaning purpose, this misinterpreted signal feeds the cycle of fibromyalgia by perpetuating muscle weakness, pain and fatigue.

While helping your client begin or stick with an exercise program demonstrates invaluable support, make certain a physician has approved of their activities. Listed below are some helpful tips on exercising with fibromyalgia from industry experts:

  1. Start slowly – Frustration for not being able to accomplish what used to be simple can easily result in giving up or doing too much. The rule for fibromyalgia is to start small, and only increase exercise gradually.
  2. Progress sequentially – Always start the journey to fitness with a regular stretching program. Stretching will release some muscle tightness, decreasing the number of pain signals going to the brain. The next phase is muscle strengthening. After flexibility and strength are increased, aerobic and endurance activities can be added.
  3. Minimize eccentric muscle loading – Simultaneous muscle contraction and lengthening is typically too demanding with fibromyalgia. When working with any muscle group, separate stretching the muscle from contracting the muscle into different exercises.
  4. Focus on posture – Making sure to find one’s center of balance will correctly distribute the body’s weight and reduce how quickly the muscles fatigue. Proper posture can help reduce unnecessarily held muscle tension.
  5. Limit muscle contraction time – Prolonged muscle contraction can perpetuate pain by fatiguing muscles too quickly. Make certain to take regular breaks from any activity. This can range from taking a break from swimming to do a two-minute stretch, or pausing for three seconds after every minute of vacuuming.

Working with fibromyalgia can be a terrifically rewarding niche for massage therapists. As one of the most encountered chronic pain syndromes in women, there is currently no medical cure for this mysterious condition. While massage therapy is one of the top-rated options for fibromyalgia, results are magnified when accompanied by a regular exercise program. The five tips listed above can help clients with fibromyalgia incorporate exercise into their health maintenance routine. By recruiting both massage and exercise into a treatment plan, fibromyalgia sufferers have a better chance of conquering this increasingly common syndrome.

Recommended Study:

Fibromyalgia and Massage

More Information:

Fibromyalgia: Massage Beneftis and Precautions


Mannerkorpi, K, Exercise in Fibromyalgia, Current Opinion in Rheumatology, March 2005., Exercising with Fibromyalgia, Paige Waehner, About, Inc., 2007., Starting an Exercise Program with Fibromyalgia, Lisa Lorden, National Fibromyalgia Association, 2007., Fibromyalgia, Mayo Foundation for Medical Education and Research, 2007., Everyday Flexibility Moves, Janice H. Hoffman, Fibromyalgia Information Foundation, 2007., A Fibromyalgia Patients Guide to Exercise, Sharon R. Clark, PhD, FNP, Fibromyalgia Information Foundation, 2007.