This easily read paper directed toward physicians with an interest in sports medicine does not report new research but rather gives an overview of fibromyalgia (FM). Much of the article deals with what is known about fitness and FM. Dr. R.B. Gremillion writes that well-trained, active people have a much lower incidence of FM than the general population. “However, active women who abruptly stop physical training at the end of a sports season or because of a chronic pain syndrome or trauma have a risk for development of FM closer to that of the general population.
Overtraining that leads to excessive muscle fatigue and tenderness can also alter sleep dynamics enough to precipitate FM.” He also writes that FM patients can become deconditioned over time as a result of chronic pain, that deconditioned muscles are more susceptible to microtrauma from minor activity, which can result in greater pain and less activity and put the patient in a downward cycle.
He recommends exercise as a treatment because it not only improves muscle conditioning but also improves restorative sleep, increases endogenous endorphins within the central nervous system and has a “profound antidepressant effect.” He cautions, however, that “because FM patients almost always experience pain after exercise, the intensity of the workout must start low and be increased gradually.”
Although the article is generally pessimistic about eliminating symptoms, it does suggest that interventions such as stretching and massage offered by a physical therapist may be particularly helpful. In discussing the parallels with CFS, Dr. Gremillion notes that up to 70% of FM patients meet strict criteria for CFS, while up to 70% of those with CFS-like illnesses have concurrent FM. Most of all, he urges doctors to take a sympathetic attitude toward the patient and respect that “fibromyalgia is a real and objective disease.”
Gremillion, R.B. (1998). Fibromyalgia: Recognizing and treating an elusive syndrome. The Physician and Sports Medicine, 26:4, 55-65.