Anne Baaner - Fibromyalgi

Fibromyalgia and Chronic Fatigue Syndrome (CFS)

Learn how to use gentle aerobics and stretching exercises to reduce the pain of Fibromyalgia.

Fibromyalgia and Chronic Fatigue Syndrome (CFS) are thought by many to be separate manifestations of the same disorder, the main difference being the major symptom associated with each of the disorders.

If you suffer from fibromyalgia or are seeking to prevent its occurrence it is important to follow the information in this article. In addition, adding a few simple stretches to your fitness program will also help. To get you started on a safe and effective stretching routine learn more about The Stretching Handbook and how it can improve your fitness.

Fibromyalgia is a chronic disorder in which the sufferer complains of severe pain throughout their body. This pain can affect the muscles, joints and soft tissues i.e. tendons and ligaments, to the extent that any movement is a struggle. This particular disorder affects the female gender in 90% of cases and is commonly diagnosed between the ages of 25 and 40 although the symptoms can begin to show at any age. Other symptoms that are used to diagnose fibromyalgia include:

  • Tenderness in 11 of the 18 pre-determined sensitive spots of the body
  • Chronic fatigue
  • Sleep disorders
  • Headaches
  • Stiffness of the joints

Many individuals diagnosed with the condition suffer with all or the vast majority of these symptoms however because fibromyalgia is a relatively new disorder many physicians mistake it for other, more common disorders. One such disorder is CFS.

CFS is another life long illness that is characterized by the above symptoms however in this case the major diagnostic symptom is fatigue, as apposed to widespread pain. The fatigue associated with the condition is often debilitating and is described by many as like "having concrete arms and legs." Muscle and joint pain is also common in CFS and so it is understandable that many experts get the two disorders confused.

The cause of fibromyalgia and CFS is still unknown although many research papers commonly refer to four possible aetiologies:

  • Toxicity - due to long term exposure to chemicals, pesticides, insecticides etc.
  • Traumatic experiences and life long stress, possibly from a pre-existing medical condition or illness.
  • Genetic susceptibility.
  • Immunological breakdown - due to prior bacterial or viral infection.

Whatever the underlying causes of the two disorders they are both as yet incurable and so treatment and management of the symptoms is seen as the key to relief. Surprisingly exercise has been found to be very beneficial with regards to reducing the pain and fatigue associated with fibromyalgia and CFS and so a regular exercise regimen needs to be tailored to each individual sufferers needs.

Precautions, Limitations and Dangers
As with any exercise plan, an exercise plan for people diagnosed with fibromyalgia or CFS needs to cater for the individual's level of fitness, mobility and experience. Extra precautions need to be taken to allow for the persons disability and so only certain types of exercise should be included.

Because many of the joints, muscles, ligaments and tendons will be affected by fibromyalgia and CFS only low impact or non-impact exercise routines should be practiced. This acts to reduce any additional stress that would normally be placed on already tender and painful spots.

Each case of fibromyalgia is different i.e. one person may only have pain in their leg muscles and joints whereas a second person may have all over pain, and this will inevitably affect the type and intensity of the exercises performed. All people with fibromyalgia or CFS should know their limitations and should thus try to stick to exercises that they know won't exacerbate their main symptoms.

Over exercising will often cause pain and soreness in even the healthiest of people and so in those already suffering with chronic pain, the intensity can effectively double making any subsequent movements absolute torture. It is important for sufferers of fibromyalgia and CFS to increase their levels of exercise very slowly and only push themselves as far as is comfortable. By overexerting themselves and causing their pain to become more intense, many sufferers of fibromyalgia will enter a period in which they refrain from all activity and effectively become inactive. This then causes de-conditioning and as a consequence, more pain.

Individuals diagnosed with either fibromyalgia or CFS need to break the above cycle by becoming active and keeping their bodies conditioned and strong.

The Best Type of Exercise for Fibromyalgia and CFS
Non-impact and low impact aerobic exercise has been found to be very beneficial for sufferers of fibromyalgia and CFS. The cardiovascular training involved with aerobic exercise has been shown to significantly reduce the degree of pain and stiffness experienced by sufferers.

Light Aerobics
For those who can manage it, low impact aerobics sessions, which can include activities such as brisk walking, cycling, using a Stairmaster etc. can be very good for reducing all levels of pain. Aerobic exercise should be performed for around 30 minutes per day, 3-4 time per week for it to have a significant effect however it is very important not to rush into things and stress the muscles and joints unnecessarily.

It is advised that people with fibromyalgia or CFS start with a simple 5 minute walk and build up gradually until they reach the 30 minute target. Pre-exercise stretching is also highly recommended as this helps to make the exercise session more comfortable and reduces the risk of injury. Regular stretching will also help with posture and flexibility while reducing the amount of muscle and joint stiffness experienced during and after the workout.

Aqua Aerobics
Water makes the body weightless and so any form of swimming or aerobic activity in water greatly benefits people with painful muscles and joints. This non-impact form of exercise takes all of the strain off the joints meaning that for a time they don't have to bear the weight of the body. This is perfect for fibromyalgia sufferers with very tender body areas who get excruciating waves of pain with every jolt. It is important however that the swimming water is warm because cold water can cause the muscles and joints to seize up and become infinitely more painful.

Stretching Exercises
Apart from the pre-exercise stretching that will be discussed in more detail as part of the following section; there are a number of exercise forms that involve specific types of stretching.

Stretching, as it relates to physical health and fitness, is the process of placing particular parts of the body into a position that will lengthen the muscles and associated soft tissues. Stretching is a simple and effective activity that helps to enhance athletic performance, decrease the likelihood of injury and minimize muscle and joint soreness.

Stretching can be practiced in the privacy of the home or at the gym where a qualified instructor can demonstrate the correct way to stretch so that the maximum benefit is achieved.

As with most activities there are rules and guidelines to ensure that they are safe. Stretching is no exception. Stretching can be extremely dangerous and harmful if done incorrectly. It is vitally important that the following guidelines be adhered to, both for safety and for maximizing the potential benefits of stretching.

Stretching Guidelines
It is incredibly important to stretch correctly as an incorrect stretch can do more harm than good, especially with regards to a fibromyalgia sufferer. There are five main things to remember when stretching which will help to keep the body in great shape and injury free.

1. Warm up the muscles prior to stretching
Cold muscles can injure very easily and so it is vitally important to warm up the body before strenuous stretching and before an exercise session. Bringing the body's core temperature up by performing a warm-up will ultimately increase the temperature of the muscles, so making them more supple and loose i.e. in the condition needed to stretch safely.

A warm up will also act to increase the heart rate and therefore the blood flow and nutrients reaching the muscles. As the breathing rate also increases, the amount of essential oxygen reaching the muscles rises dramatically, again creating the perfect internal environment for safe stretching.

A safe warm up for a fibromyalgia or a CFS sufferer might consist of a brisk walk or a short swim. The warm up should not last more than 10 minutes and it shouldn't be overly strenuous, especially if the individual's level of fitness is relatively low or severe pain is experienced.

2. Stretch slowly with gentle movements
Slow gentle stretching helps to relax the muscles of the body, which is often highly beneficial to the fibromyalgia sufferer. Jerky movements or over-stretching can lead to increased pain, muscle strain and even muscle tears and so all stretches should be done as if in slow motion and as smoothly as possible.

3. Stretch only as far as is comfortable
Over stretching is one of the major causes of muscle strains and tears and so it is important that individual muscles are only stretched as far as is comfortable. The idea of stretching is to relax the muscles and make the body generally more flexible which, in the case of fibromyalgia and CFS, can reduce the amount of pain felt in specific areas of the body. Over stretching a muscle can cause the tendons and ligaments attached to the muscle to spontaneously contract and this can cause major problems if the stretch is then forced beyond the comfort level. Stretching should never be painful and if it is then it is a sure bet that the muscle concerned is being greatly over stretched.

4. Control of breathing while stretching
It is important to concentrate on breathing while stretching as many individuals have a tendency to hold their breath and often they don't even realize they are doing it. Unfortunately holding the breath can cause the muscles to tense up and trying to stretch tensed muscles will, more often than not, lead to injury, especially in fibromyalgia sufferers who already have tense and painful muscles. Holding the breath also limits the amount of oxygen and nutrients reaching the muscles and if this anaerobic state continues for any significant length of time, the muscles will build up lactic acid and become highly painful, which is the opposite of what stretching is supposed to achieve.

5. Stretching correctly
Each stretch should ideally be held for around 30 seconds for the maximum beneficial effect. Anything less than this will not provide a sufficient length of time for the muscle to relax and lengthen. In addition each muscle group needs to be stretched two or three times in rotation and this is considered the bare minimum. Fibromyalgia sufferers may initially have trouble stretching to this extent and so should only stretch until they begin to feel uncomfortable. Any form of stretching is better than no stretching at all and so even a few minutes is worth doing.

People diagnosed with fibromyalgia or CFS will benefit from stretching on a daily basis but it is vitally important that they don't overexert themselves on a particular day as the following day may be more painful than the person can bare, in which case the beneficial cycle will be broken i.e. the pain causes inactivity which continues for a number of days or even weeks and this eventually causes even more pain.

Diet and Exercise Can Calm Fibromyalgia Symptoms


A healthy diet and regular exercise are essential to anyone who wants to feel well. For someone with fibromyalgia, those two things play a critical role in helping to reduce pain, increase energy and improve quality of life.

Studies have shown that walking, strength training, stretching exercises and swimming in a heated pool can alleviate fibromyalgia symptoms. Regular exercise appears to enhance the body’s response to stress, which often triggers symptoms. It also improves endocrine function to help the body better process pain and regulate sleep patterns.

Here are the keys to an effective exercise program:

  • Start slowly. Begin with gentle stretching, walking, bicycling or swimming.


  • Create a routine. Exercise should be a regular part of your life. Schedule time for it on your weekly calendar and take advantage of small opportunities to exercise throughout your day, such as using the stairs instead of the elevator.


  • Have fun with it. Yoga, Pilates, strength training, tai chi, bicycling, walking, jogging, low-impact aerobics or swimming all are recommended. Mix it up so you won’t get bored.

While exercise is one of the most proven ways to battle fibromyalgia, the jury is still out on the issue of nutrition. A balanced diet can help increase your energy level and reduce your risk of other health problems, but more research is needed before experts can identify if specific foods affect the risk of flare-ups. Many people with fibromyalgia, however, have reported a reduction in symptoms by avoiding certain things, such as caffeine and alcohol. Experiment by cutting foods from your diet that seem to intensify your symptoms. To maintain your health, though, make sure your diet remains well-balanced.

Put Together Your Fibromyalgia Treatment Plan


If you have the flu, spend a few days in bed, and you’ll likely feel better. Fibromyalgia is different. Symptoms are eased, never cured, and there is no one “remedy” that works for everyone. For these reasons, fibromyalgia patients should develop a personalized treatment plan to minimize flare-ups and the severity of symptoms.

Identify your symptoms
Widespread, chronic pain is a hallmark of fibromyalgia. It’s diagnosed by the presence of tenderness in 18 specific points of the body, with at least 11 of those 18 spots being abnormally tender, even when mildly touched. Fatigue, sleep, and memory and concentration problems (often called “fibro fog”) also are common symptoms of fibromyalgia. You might also experience restless legs syndrome, irritable bowel syndrome, painful menstruation, depression, dry eyes, anxiety or headaches. Make sure you work with your doctor to treat all of your ailments.

Find the right medications
To date, pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella) are the only medications approved by the U.S. Food and Drug Administration (FDA) to treat fibromyalgia pain. Tricyclic antidepressants often have been found to be the most efficacious medications for fibromyalgia, especially since sleep and fatigue problems respond well to some antidepressants. But other painkillers, from over-the-counter ibuprofen to prescription-only narcotics, also are prescribed.

Talk to your doctor about what will give you the greatest relief with the fewest side effects. Because there are so many medications to choose from, you may need to use trial and error to help determine which is best for you. If antidepressants don’t work, you may need to incorporate sleep aids or muscle relaxants into your treatment plan.

Explore alternative treatments
For many people, massage and acupuncture, as well as Pilates, tai chi, chiropractic treatment, and various dietary supplements, can provide relief. You also may find it helpful to work with a physician who incorporates complementary medicine into his or her practice.

Make healthy changes
Stress reduction, a healthy diet and regular exercise can reduce fibromyalgia flare-ups, so lifestyle changes should be a part of your treatment plan. Sleep also is crucial for managing symptoms. Devising a treatment plan will require coordinating with your primary care doctor and/or a rheumatologist, physical therapist, naturopathic physician (if you use one) and other health professionals. Make sure everyone on your health care team is aware of your plan, and consult your doctor before making adjustments.


Manage Stress, Manage Fibromyalgia


The following is an Editorial Resource from YourTotalHealth.

Reviewed by:  Steven A. King, M.D.

hapes="_x0000_i1026">When you have fibromyalgia, stress has a powerful grip on your life. It can cause the disease to flare-up, resulting in shooting pains, extreme fatigue, and cognitive problems like confusion and memory loss—often called “fibro fog.” In fact, many people report that a traumatic event brought on their first symptoms of fibromyalgia, leading some researchers to speculate that stress can actually trigger the disease. The National Institute of Arthritis and Musculoskeletal and Skin Diseases currently is funding research into whether fibromyalgia is caused by a breakdown in the way the body responds to stress.

Stress is known to trigger flare-ups in people with fibromyalgia, so restoring calm to your everyday life can help reduce your symptoms. Here are some coping techniques that can help you have more pain-free days.

Identify Your Stressors
Analyze your day and look for potential stress hot spots. For example, some people don’t mind sitting in traffic, but others fume as they creep along during rush hour. If you feel hurried to get out the door on time every morning, consider waking up earlier (and going to bed earlier to compensate). If talking on the phone to a certain family member is stressful, consider changing to an email-only relationship. Figure out which situations you can control and make the necessary adjustments to make your days easier.

Develop Coping Techniques
Much of life’s stress is unavoidable, but you can learn to react to it while keeping your calm:

  • Schedule time to relax or meditate every day. The more you do it, the better you’ll get at relaxing. Then, when you experience a sudden stressful situation, such as a heated discussion with your boss, you’ll know how to take a few minutes afterward for deep breathing exercises or a short walk.
  • Don’t dwell on the past. One component of stress involves regret over things we could have done differently. Live in the moment and focus on what you need to do now to control your illness.
  • Request accommodations at work. If your fibromyalgia makes mornings difficult, ask to work from t="on">10 a.m. to 6 p.m., for example, instead of from t="on">9 a.m. to 5 p.m. If sitting at your desk all day leaves your body aching, ask for a better chair or for regular breaks so you can walk and stretch.
  • Find support. Talk to others who have fibromyalgia to share coping strategies and encouragement during your bad days.

Managing stress will not cure your fibromyalgia, but it can help you gain some control over your symptoms. Allow yourself to relax and your body will thank you.


Proper Sleep Is Crucial to Managing Fibromyalgia


hapes="_x0000_i1027">It’s a vicious cycle: A poor night’s sleep makes your fibromyalgia symptoms worse, and then the pain makes it hard to fall asleep at night. Restless legs syndrome, a problem for many people with fibromyalgia, also can keep you from getting the rest you need.

Sleep is a crucial piece of the fibromyalgia puzzle. In fact, some research shows that disruptions during the deepest levels of sleep can cause the onset of fibromyalgia symptoms.

Try these suggestions to get better sleep:

Adopt a daily routine
Try to go to bed and wake up at the same time each day. Avoid daytime napping and create a nighttime relaxation ritual. This could include a warm bath, reading or listening to music as a way to wind down.

Watch your diet
Avoid caffeine and alcohol in the late afternoon and evening. Caffeine can make it harder to fall asleep and alcohol can disrupt sleep. Also, avoid spicy or fried foods if they cause heartburn or indigestion. And so your bladder won’t wake you, try not to consume any liquids right before bed.

Time your workouts
Exercise can help you sleep better at night. Some experts advise finishing at least three hours before bedtime because the stimulation may make it difficult to fall asleep right away. Others, however, point out that exercise can relax you and help you fall asleep shortly after participating in it.

Medication can help
If lifestyle changes are not enough, medication is an option. Tricyclic antidepressants can help you achieve restorative sleep, but they may leave you drowsy during the day. If you have restless legs syndrome, your doctor may prescribe sedatives such as diazepam (Valium). On the downside, the extended use of benzodiazepines can lower your pain threshold and ultimately exacerbate pain. Plus, they can be extremely addictive. Sleep medications and muscle relaxants can also help, so talk to your doctor about your options.

Test Your Tender Points


The following is an Editorial Resource from YourTotalHealth.

Reviewed by:  Steven A. King, M.D.


In 1990 the American College of Rheumatology developed the tender point exam, which maps 18 specific points on the body that are extremely sensitive in people with fibromyalgia. In order for your doctor to diagnose you with fibromyalgia, you need to experience pain in at least 11 of these points and have constant, widespread pain for at least three months.

When mild pressure is applied to any of these soft-tissue tender point areas around the neck, shoulder, chest, hip, knee and elbow regions, a patient with fibromyalgia often experiences it as pain. Another symptom: applying pressure to these points may trigger pain in a larger region, such as down your leg.

If you have widespread, frequent pain, above and below the waist, on both sides of your body, and in the neck, chest, or back, ask your doctor to administer the tender point test for a definitive fibromyalgia diagnosis. Once you’ve gotten a diagnosis you can begin to create a treatment plan to help you manage your symptoms.

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