Fibromyalgia & Chronic Pain LIFE Winter 2014, Issue 10 | Page 16

Self-Management Tools for those with FM. This may be the result of poor sleep, or lowered levels of the growth hormone IGF-1 that occurs in some persons with FM. • Don’t attempt to work out through a flare; postpone the more vigorous kinds of activity. Instead, do range of motion and flexibility work as tolerated. This is the key to keeping the joints and muscles from locking up. Once flare symptoms recede, a gradual increase in activity and exercise is the right road to recovery. • Exercise can reduce overall fatigue and improve sleep in FM over time, although it does NOT necessarily improve pain levels. However, exercise does appear to help control pain in some individuals. ‘one-size-fits-all’ standard fitness regimes. T he primary goals of any activity and exercise program include maintaining muscle and bone mass, maintaining normal range-or-motion, and gaining stamina. These benefits are important for everyone, whether we enjoy good health or are dealing with chronic pain. An activity and exercise program that is designed for fibromyalgia and chronic pain can reach these same goals. H ere is what we know about the mechanisms and benefits of exercising with FM: • Painful muscles during and after exercise does not mean damage taking place in FM exercisers. Research has shown that gradually strengthening muscles, including muscles that hurt, causes no structural damage. 16  Fibromyalgia & Chronic Pain Life • Exercise does not automatically increase pain or fatigue for those with fibromyalgia. When FMspecific modifications are in place, gradual improvement without flares is quite possible. Workouts modified for FM can release tight muscles and produce increased mobility, better posture, and less pain near joints. • The typical “feel good” endorphin release experienced by the general population is often not present in those with FM. Many months can go by before a higher activity level begins to feel good. Realizing this can help set realistic benchmarks for signs of improvement. • The “standard” fitness workout that might cause only a small amount of postworkout soreness in a healthy beginner can quickly produce delayed onset muscle soreness Winter 2014 • Establish a consistent program, and play it smart. Do not “attack” an exercise program as soon as you have a remission, hoping to make up for lost ground. Success will come from starting slow and focusing on the long term. • A recent study of FM subjects found significant differences when they exercised at their own preferred pace versus a prescribed pace. Overall decreases in pain intensity with increases in pain threshold occurred only in the preferred group. The take away message? Take in stride the expectations of others. W hat follows is a step-by-step program outline that can help improve daily function and physical health without increasing pain levels. This ‘exercise prescription’ has been developed in conjunction with the Oregon Health & Science University Fibromyalgia Research and Treatment Team, and is based on solid research findings.