https://doi.org/10.4081/ejtm.2023.11423
The effectiveness of aerobic exercise for pain management in patients with fibromyalgia
Submitted: 19 April 2023
Accepted: 5 June 2023
Published: 14 July 2023
Accepted: 5 June 2023
Abstract Views: 2467
PDF: 1342
HTML: 46
HTML: 46
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The effectiveness of exercise therapy is being increasingly studied in patients with fibromyalgia. The aim of our systematic review was to determine the effectiveness of different types of aerobic exercise programs for pain management in patients with fibromyalgia. The literature search was performed by two independent researchers in the PubMed, CINAHL and PEDro databases using various combinations of the following keywords: fibromyalgia, pain and aerobic exercise. Studies were eligible if they included adults diagnosed with fibromyalgia and examined the effectiveness of at least one aerobic exercise program on pain management. A total of 14 randomized controlled trials were screened in full-text, nine of which were included in the systematic review. Overall, our results indicate that aerobic exercise is effective for pain management in patients with fibromyalgia. The results of the aerobic exercise programs were more effective for pain management than stretching exercises, but did not differ significantly from those of pilates, muscle strengthening exercises, relaxation techniques and stress management treatment. Additional high-quality studies are warranted to determine accurate clinical guidelines in terms of aerobic exercise programs for pain management in patients with fibromyalgia.
Siracusa R, Paola RD, Cuzzocrea S, Impellizzeri D. Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. Int J Mol Sci. 2021 Apr 9;22(8):3891. PMID: 33918736; PMCID: PMC8068842.
DOI: https://doi.org/10.3390/ijms22083891
Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, Barton DL, St Sauver J. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013 May;65(5):786-92. PMID: 23203795; PMCID: PMC3935235.
DOI: https://doi.org/10.1002/acr.21896
Branco JC, Bannwarth B, Failde I, Abello Carbonell J, Blotman F, Spaeth M, Saraiva F, Nacci F, Thomas E, Caubère JP, Le Lay K, Taieb C, Matucci-Cerinic M. Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum. 2010 Jun;39(6):448-53. Epub 2009 Feb 27. PMID: 19250656.
DOI: https://doi.org/10.1016/j.semarthrit.2008.12.003
Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995 Jan;38(1):19-28. PMID: 7818567.
DOI: https://doi.org/10.1002/art.1780380104
McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2007 Jun;21(3):403-25. PMID: 17602991.
DOI: https://doi.org/10.1016/j.berh.2007.03.003
Gerdle B, Björk J, Cöster L, Henriksson K, Henriksson C, Bengtsson A. Prevalence of widespread pain and associations with work status: a population study. BMC Musculoskelet Disord. 2008 Jul 15;9:102. PMID: 18627605; PMCID: PMC2488345.
DOI: https://doi.org/10.1186/1471-2474-9-102
Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007 Mar 9;8:27. PMID: 17349056; PMCID: PMC1829161.
DOI: https://doi.org/10.1186/1471-2474-8-27
Bradley LA. Pathophysiology of fibromyalgia. Am J Med. 2009 Dec;122(12 Suppl):S22-30. PMID: 19962493; PMCID: PMC2821819.
DOI: https://doi.org/10.1016/j.amjmed.2009.09.008
Yunus MB, Khan MA, Rawlings KK, Green JR, Olson JM, Shah S. Genetic linkage analysis of multicase families with fibromyalgia syndrome. J Rheumatol. 1999 Feb;26(2):408-12. PMID: 9972977.
Bhargava J, Hurley JA. Fibromyalgia. 2022 Oct 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31082018.
de Medeiros SA, de Almeida Silva HJ, do Nascimento RM, da Silva Maia JB, de Almeida Lins CA, de Souza MC. Mat Pilates is as effective as aquatic aerobic exercise in treating women with fibromyalgia: a clinical, randomized and blind trial. Adv Rheumatol. 2020 Apr 6;60(1):21. PMID: 32252822.
DOI: https://doi.org/10.1186/s42358-020-0124-2
Andrés-Rodríguez L, Borràs X, Feliu-Soler A, Pérez-Aranda A, Angarita-Osorio N, Moreno-Peral P, Montero-Marin J, García-Campayo J, Carvalho AF, Maes M, Luciano JV. Peripheral immune aberrations in fibromyalgia: A systematic review, meta-analysis and meta-regression. Brain Behav Immun. 2020 Jul;87:881-889. Epub 2019 Dec 27. PMID: 31887417.
DOI: https://doi.org/10.1016/j.bbi.2019.12.020
Buskila D, Atzeni F, Sarzi-Puttini P. Etiology of fibromyalgia: the possible role of infection and vaccination. Autoimmun Rev. 2008 Oct;8(1):41-3. Epub 2008 Aug 13. PMID: 18706528.
DOI: https://doi.org/10.1016/j.autrev.2008.07.023
Kocyigit BF, Akyol A. The relationship between COVID-19 and fibromyalgia syndrome: prevalence, pandemic effects, symptom mechanisms, and COVID-19 vaccines. Clin Rheumatol. 2022 Oct;41(10):3245-3252. Epub 2022 Jul 8. PMID: 35804273.
DOI: https://doi.org/10.1007/s10067-022-06279-9
Reshkova V, Kalinova D, Milanov I. Evaluation of antiviral antibodies against Epstein-Barr Virus and neurotransmitters in patients with fibromyalgia. J. Neurol Neurosci. 2015;6.
Lichtenstein A, Tiosano S, Amital H. The complexities of fibromyalgia and its comorbidities. Curr Opin Rheumatol. 2018 Jan;30(1):94-100. PMID: 29040155.
DOI: https://doi.org/10.1097/BOR.0000000000000464
White KP, Harth M. The occurrence and impact of generalized pain. Baillieres Best Pract Res Clin Rheumatol. 1999 Sep;13(3):379-89. PMID: 10562368.
DOI: https://doi.org/10.1053/berh.1999.0027
Kratz AL, Davis MC, Zautra AJ. Pain acceptance moderates the relation between pain and negative affect in female osteoarthritis and fibromyalgia patients. Ann Behav Med. 2007 Jun;33(3):291-301. PMID: 17600456; PMCID: PMC2593934.
DOI: https://doi.org/10.1007/BF02879911
Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, Choy E, Kosek E, Amris K, Branco J, Dincer F, Leino-Arjas P, Longley K, McCarthy GM, Makri S, Perrot S, Sarzi-Puttini P, Taylor A, Jones GT. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017 Feb;76(2):318-328. Epub 2016 Jul 4. PMID: 27377815.
DOI: https://doi.org/10.1136/annrheumdis-2016-209724
Turk DC. Customizing treatment for chronic pain patients: who, what, and why. Clin J Pain. 1990 Dec;6(4):255-70. PMID: 2135025.
DOI: https://doi.org/10.1097/00002508-199012000-00002
McCracken LM. Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain. 1998 Jan;74(1):21-27. PMID: 9514556.
DOI: https://doi.org/10.1016/S0304-3959(97)00146-2
Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000 Apr;85(3):317-332. PMID: 10781906.
DOI: https://doi.org/10.1016/S0304-3959(99)00242-0
Tangen SF, Helvik AS, Eide H, Fors EA. Pain acceptance and its impact on function and symptoms in fibromyalgia. Scand J Pain. 2020 Oct 25;20(4):727-736. PMID: 32759409.
DOI: https://doi.org/10.1515/sjpain-2020-0049
Booth J, Moseley GL, Schiltenwolf M, Cashin A, Davies M, Hübscher M. Exercise for chronic musculoskeletal pain: A biopsychosocial approach. Musculoskeletal Care. 2017 Dec;15(4):413-421. Epub 2017 Mar 30. PMID: 28371175.
DOI: https://doi.org/10.1002/msc.1191
Häuser W, Thieme K, Turk DC. Guidelines on the management of fibromyalgia syndrome - a systematic review. Eur J Pain. 2010 Jan;14(1):5-10. Epub 2009 Mar 4. PMID: 19264521.
DOI: https://doi.org/10.1016/j.ejpain.2009.01.006
Tzellos TG, Toulis KA, Goulis DG, Papazisis G, Zampeli VA, Vakfari A, Kouvelas D. Gabapentin and pregabalin in the treatment of fibromyalgia: a systematic review and a meta-analysis. J Clin Pharm Ther. 2010 Dec;35(6):639-56. PMID: 21054455.
DOI: https://doi.org/10.1111/j.1365-2710.2009.01144.x
Arnold LM, Clauw DJ, Wohlreich MM, Wang F, Ahl J, Gaynor PJ, Chappell AS. Efficacy of duloxetine in patients with fibromyalgia: pooled analysis of 4 placebo-controlled clinical trials. Prim Care Companion J Clin Psychiatry. 2009;11(5):237-44. PMID: 19956462; PMCID: PMC2781036.
DOI: https://doi.org/10.4088/PCC.08m00680
Arnold LM. Duloxetine and other antidepressants in the treatment of patients with fibromyalgia. Pain Med. 2007 Sep;8 Suppl 2:S63-74. PMID: 17714117.
DOI: https://doi.org/10.1111/j.1526-4637.2006.00178.x
Chen J, Han B, Wu C. On the superiority of a combination of aerobic and resistance exercise for fibromyalgia syndrome: A network meta-analysis. Front Psychol. 2022 Sep 28;13:949256. PMID: 36248603; PMCID: PMC9554347.
DOI: https://doi.org/10.3389/fpsyg.2022.949256
Jones KD, Adams D, Winters-Stone K, Burckhardt CS. A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988-2005). Health Qual Life Outcomes. 2006 Sep 25;4:67. PMID: 16999856; PMCID: PMC1590013.
DOI: https://doi.org/10.1186/1477-7525-4-67
Busch AJ, Barber KA, Overend TJ, Peloso PM, Schachter CL. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003786. PMID: 17943797.
DOI: https://doi.org/10.1002/14651858.CD003786.pub2
Bidonde J, Busch AJ, Schachter CL, Overend TJ, Kim SY, Góes SM, Boden C, Foulds HJ. Aerobic exercise training for adults with fibromyalgia. Cochrane Database Syst Rev. 2017 Jun 21;6(6):CD012700. PMID: 28636204; PMCID: PMC6481524.
DOI: https://doi.org/10.1002/14651858.CD012700
Sosa-Reina MD, Nunez-Nagy S, Gallego-Izquierdo T, Pecos-Martín D, Monserrat J, Álvarez-Mon M. Effectiveness of Therapeutic Exercise in Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Biomed Res Int. 2017;2017:2356346. Epub 2017 Sep 20. PMID: 29291206; PMCID: PMC5632473.
DOI: https://doi.org/10.1155/2017/2356346
Couto N, Monteiro D, Cid L, Bento T. Effect of different types of exercise in adult subjects with fibromyalgia: a systematic review and meta-analysis of randomised clinical trials. Sci Rep. 2022 Jun 20;12(1):10391. PMID: 35725780; PMCID: PMC9209512.
DOI: https://doi.org/10.1038/s41598-022-14213-x
Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014 Nov 21;14:579. PMID: 25413154; PMCID: PMC4310146.
DOI: https://doi.org/10.1186/s12913-014-0579-0
Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther. 2003 Aug;83(8):713-21. PMID: 12882612.
DOI: https://doi.org/10.1093/ptj/83.8.713
Sevimli D, Kozanoglu E, Guzel R, Doganay A. The effects of aquatic, isometric strength-stretching and aerobic exercise on physical and psychological parameters of female patients with fibromyalgia syndrome. J Phys Ther Sci. 2015 Jun;27(6):1781-6. Epub 2015 Jun 30. PMID: 26180320; PMCID: PMC4499983.
DOI: https://doi.org/10.1589/jpts.27.1781
Hooten MW, Qu W, Townsend CO, Judd JW. Effects of strength vs aerobic exercise on pain severity in adults with fibromyalgia: a randomized equivalence trial. Pain. 2012 Apr;153(4):915-923. Epub 2012 Feb 15. PMID: 22341565.
DOI: https://doi.org/10.1016/j.pain.2012.01.020
Mannerkorpi K, Nordeman L, Cider A, Jonsson G. Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial. Arthritis Res Ther. 2010;12(5):R189. Epub 2010 Oct 13. PMID: 20942911; PMCID: PMC2991024.
DOI: https://doi.org/10.1186/ar3159
Assis MR, Silva LE, Alves AM, Pessanha AP, Valim V, Feldman D, Neto TL, Natour J. A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia. Arthritis Rheum. 2006 Feb 15;55(1):57-65. PMID: 16463414.
DOI: https://doi.org/10.1002/art.21693
Valim V, Oliveira L, Suda A, Silva L, de Assis M, Barros Neto T, Feldman D, Natour J. Aerobic fitness effects in fibromyalgia. J Rheumatol. 2003 May;30(5):1060-9. PMID: 12734907.
Schachter CL, Busch AJ, Peloso PM, Sheppard MS. Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: a randomized controlled trial. Phys Ther. 2003 Apr;83(4):340-58. PMID: 12665405.
DOI: https://doi.org/10.1093/ptj/83.4.340
Richards SC, Scott DL. Prescribed exercise in people with fibromyalgia: parallel group randomised controlled trial. BMJ. 2002 Jul 27;325(7357):185. PMID: 12142304; PMCID: PMC117444.
DOI: https://doi.org/10.1136/bmj.325.7357.185
Wigers SH, Stiles TC, Vogel PA. Effects of aerobic exercise versus stress management treatment in fibromyalgia. A 4.5 year prospective study. Scand J Rheumatol. 1996;25(2):77-86. PMID: 8614771.
DOI: https://doi.org/10.3109/03009749609069212
Hoffman MD, Shepanski MA, Ruble SB, Valic Z, Buckwalter JB, Clifford PS. Intensity and duration threshold for aerobic exercise-induced analgesia to pressure pain. Arch Phys Med Rehabil. 2004 Jul;85(7):1183-7. PMID: 15241771.
DOI: https://doi.org/10.1016/j.apmr.2003.09.010
Millan MJ. Descending control of pain. Prog Neurobiol. 2002 Apr;66(6):355-474. PMID: 12034378.
DOI: https://doi.org/10.1016/S0301-0082(02)00009-6
Van Oosterwijck J, Nijs J, Meeus M, Van Loo M, Paul L. Lack of endogenous pain inhibition during exercise in people with chronic whiplash associated disorders: an experimental study. J Pain. 2012 Mar;13(3):242-54. Epub 2012 Jan 24. PMID: 22277322.
DOI: https://doi.org/10.1016/j.jpain.2011.11.006
Meeus M, Roussel NA, Truijen S, Nijs J. Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study. J Rehabil Med. 2010 Oct;42(9):884-90. PMID: 20878051.
DOI: https://doi.org/10.2340/16501977-0595
Lannersten L, Kosek E. Dysfunction of endogenous pain inhibition during exercise with painful muscles in patients with shoulder myalgia and fibromyalgia. Pain. 2010 Oct;151(1):77-86. PMID: 20621420.
DOI: https://doi.org/10.1016/j.pain.2010.06.021
Bender T, Karagülle Z, Bálint GP, Gutenbrunner C, Bálint PV, Sukenik S. Hydrotherapy, balneotherapy, and spa treatment in pain management. Rheumatol Int. 2005 Apr;25(3):220-4. Epub 2004 Jul 15. PMID: 15257412.
DOI: https://doi.org/10.1007/s00296-004-0487-4
Sedlock DA, Lee MG, Flynn MG, Park KS, Kamimori GH. Excess postexercise oxygen consumption after aerobic exercise training. Int J Sport Nutr Exerc Metab. 2010 Aug;20(4):336-49. PMID: 20739722.
DOI: https://doi.org/10.1123/ijsnem.20.4.336
Imamura H, Shibuya S, Uchida K, Teshima K, Masuda R, Miyamoto N. Effect of moderate exercise on excess post-exercise oxygen consumption and catecholamines in young women. J Sports Med Phys Fitness. 2004 Mar;44(1):23-9. PMID: 15181386.
Nørregaard J, Bülow PM, Lykkegaard JJ, Mehlsen J, Danneskiold-Samsøoe B. Muscle strength, working capacity and effort in patients with fibromyalgia. Scand J Rehabil Med. 1997 Jun;29(2):97-102. PMID: 9198259.
van Santen M, Bolwijn P, Landewé R, Verstappen F, Bakker C, Hidding A, van Der Kemp D, Houben H, van der Linden S. High or low intensity aerobic fitness training in fibromyalgia: does it matter? J Rheumatol. 2002
How to Cite
Manojlović, D., & Kopše, E. I. (2023). The effectiveness of aerobic exercise for pain management in patients with fibromyalgia. European Journal of Translational Myology, 33(3). https://doi.org/10.4081/ejtm.2023.11423
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Nicola Manocchio, Isabella Iovene, Antonio Santoro, Maria Chiara Maccarone, Calogero Foti, Report and Abstracts of the 15th Congress of the Mediterranean Forum of Physical and Rehabilitation Medicine: Rome, July 6-8, 2023 , European Journal of Translational Myology: Vol. 33 No. 4 (2023)
- The Editors, Abstracts of the 2017 Spring Padua Muscle Days: Translational Myology for Impaired Mobility | Euganei Hills, Padua, Italy, March 23-25, 2017 , European Journal of Translational Myology: Vol. 27 No. 2 (2017)
You may also start an advanced similarity search for this article.