Exercise and Pain Manegement with Fibromyalgia

Fibromyalgia causes real, persistent pain driven by an over-sensitive nervous system. Science shows that properly prescribed exercise can reduce pain, improve sleep, and help the body feel safe again.

 Fibromyalgia is not “pain without a cause,” nor exaggeration, nor weakness. It is a real, complex, and deeply exhausting condition in which the nervous system becomes over-sensitive, like an alarm that sounds too loudly even when there is no danger.

People living with fibromyalgia do not only experience pain. They often:

• Wake up feeling unrefreshed
• Struggle with mental fog
• Sleep poorly
• Hear phrases like “it’s all in your head.”

What is really happening in fibromyalgia?

In fibromyalgia, the main problem is not the muscles or joints, but how the brain processes signals.

• The nervous system amplifies pain. just as chronic pain, damaging the "signal."
• Normal sensations are interpreted as threats.
• The body stays in a constant “alert mode.”

This is known as central sensitization. And here is a key point that for years was misunderstood:

Exercise does not worsen fibromyalgia when it is prescribed correctly

• Poorly dosed exercise does
• Exercise is not punishment: it is a safety signal for the nervous system

We now know that exercise works as a pain modulator, not just as a way to strengthen muscles.

When properly adapted, exercise:

• Calms an overactive nervous system
• Activates the body’s natural pain-relief mechanisms
• Improves sleep quality
• Reduces morning stiffness
• Helps restore trust in the body.

In simple terms, well-dosed movement teaches the brain that the body is safe again. What kind of exercise helps with fibromyalgia?

Exercises with the strongest evidence (but need to be personalized):

• Gentle walking
• Low-intensity aerobic exercise
• Very gradual strength training
• Slow mobility and stretching
• Tai Chi (Mind–body movement, such as controlled breathing and fluid, mindful movements)

Exercises that often worsen symptoms at the beginning:

• Hgh-intensity routines
• Demanding or competitive workouts
• “Push through the pain” programs
• Comparing oneself to people without chronic pain.

Truths about Living with Fibromyalgia

An important truth: pain may increase at first (and that does not mean harm). Many people stop exercising because pain increases during the first days or weeks. This does not necessarily mean injury or damage. It usually means the nervous system is not yet used to the stimulus. The difference between improvement and worsening depends on the Intensity, progression, and the guidance you have along the way. Things as simple as saying something like this out loud help! 

“My body is not broken — it is sensitive. I will learn to feel safe again.”

Telling a person with fibromyalgia:

• “You just have to push through."
• “The pain is psychological.l"
• “If it hurts, you are not trying hard enoug.h"

… increases pain.

Explaining what is happening in the body, validating the experience, and moving step by step reduces fear — and fear is one of the strongest amplifiers of pain.

Exercise as treatment, not as an obligation

Current scientific evidence is clear. Exercise is one of the most effective treatments for fibromyalgia when it is individualized and progressive.

It is not about racing.

It is not about performance.

It is not about proving strength.

It is about reconnecting with the body — slowly and safely.

If you have fibromyalgia, you are not failing because movement hurts.

Your nervous system learned to protect you too strongly. With the right kind of exercise, clear explanations, and proper support, it can learn something new.

Moving is not betraying yourself.

Moving the right way is caring for yourself.

Living with fibromyalgia is not about fighting your body, but about understanding it. When movement is gentle, guided, and progressive, it becomes a tool for relief rather than pain. Science now supports what many patients feel: the right kind of exercise can help the body relearn safety and restore confidence, one step at a time.

Dra. Kyo-Sai Young

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email info@medicalsportclinic.com

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