By: Anita Boser, LMP, CHP
Reprinted from FMOnline

With all the juggling required by modern life, it helps to have a few tricks up your sleeve. People who live with fibromyalgia need an extra dose of “magic” to cope with the daily pain and fatigue that can become as restrictive as a straightjacket. In 2006, the Oregon Health & Science University reviewed 46 exercise treatment studies for people with fibromyalgia. It showed that aerobic exercise is an effective prescription for fitness and symptom improvement.

The experts agree that exercise is vital, but as anyone who has chronic pain can tell you, it’s not easy. When you’re too tired to wash the kitchen counters, exercise seems self-indulgent. On the days when getting out of bed is a heroic task, even the smallest extra effort feels impossible. And any over-exertion can exacerbate symptoms for days. Escaping this trap doesn’t require the secrets of Houdini, however. You can learn from three women who’ve developed personalized routines to help them break free from the exercise pain cycle.

First meet Lorna Schripsema. Her instant smile and perfectly-styled, strawberry blonde hair hide the fact that she is in pain every day. She was diagnosed with fibromyalgia last summer, after five years of symptoms. While her treatment takes the edge off her pain, she is still exploring options to feel better. Her highly active terrier-collie, Devin, encourages her to walk every day and to “put one foot in front of the other and just get it done.” She knows she needs to keep moving, but struggled to find the exercise formula that works best for her.

Good Living with Fibromyalgia outlines the three essentials of an exercise program: 1) warm-up, 2) endurance, and 3) cool-down. Lorna had been focusing on endurance ?walking?with a bit of stretching throughout the day. Then, for a warm-up, she added undulation, a gentle exercise that strengthens and lubricates the muscles around the spine. In addition, she stretched after each walk when her muscles were warm and limber. The combination and sequence of undulation, walking, and stretching have improved Lorna’s ability to maintain consistent exercise and reduce her need for pain medication. must be tailored for the person and the day—especially for those who live with chronic pain. The Oregon Health & Science University review elaborated on the initial finding: “In general, the greatest effect and lowest attrition occurred in exercise programs that were of lower intensity than those of higher intensity . . . Increased health and fitness, along with symptom reduction, can be expected with exercise that is of appropriate intensity, self-modified, and symptom-limited.” O’Bar is a woman with pink cheeks and lovely hand gestures who loves to “live life 24-7.” She used to skimp on sleep so she could jam more activity into every day, including her favorite exercise, NiaÃ’, a combination of dance, martial arts, and movement therapies. Fibromyalgia suddenly turned her life upside down, creating weakness so severe she couldn’t lift a coffee cup. With even the smallest amount of exercise out of the question, she gained 50 lbs., and all activity became arduous.

After five years of learning to live with fibromyalgia, Hadijah rejoined a Nia class—an important step in reclaiming her liveliness. The instructor encouraged her to honor her body and to modify the routine when needed. Some students have even done the dance exercises sitting in a chair. Hadijah now goes to a Nia class two to three times a week, when she can, and has added variety with walking and going to Curves.

The key is to personalize every exercise. How? Inesa Levitz, MD, of Fibromyalgia and Fatigue Centers has this advice: “When muscles start to ache, exercise should be stopped, even if it’s much less than the patient wants to accomplish. Fibromyalgia patients are overachievers; they push themselves too hard and when they exercise too much, they pay with significant pain for three to four days or more.”

When a movement causes increased pain, the best thing to do is stop! If you want to continue, try a variation. Decrease your intensity. Move less, smaller, or slower, whatever it takes to avoid the pain. If you move without discomfort, you’ll eventually be able to do more. back your activity level can be one of the most challenging aspects of adapting to and overcoming fibromyalgia. That was the case for Nancy Long, a convivial mental health counselor. Her symptoms began after a hysterectomy and a fall down the stairs in 1993. At first she was frustrated because there was “no real understanding or cure.” Without guidance, she continued her regular activities, such as building a rock retaining wall in her back yard, which sent her into a tailspin of arbitrary pains that popped up for weeks.

Through a process of trial and error, Nancy discovered how to manage her exercise. The key is “mindful attention to the body’s signals and gentle response to them.” Her ritual, every morning and evening, combines yoga, stretching, and undulation and is altered based on her energy level. This daily practice, in conjunction with diet changes, has dramatically decreased her symptoms. bottom line: honor your body and personalize your routine. Add a warm-up and cool-down to every exercise and new, gentle activities for variety. Modify the intensity to match your ability, which changes every day. Let your symptoms set the limit on what and how much you do. Adapt these tricks to your own situation, and you’ll feel like the magician—rather than the lady who’s been cut in half!
Anita Boser, LMP, CHP practices Hellerwork Structural Integration in Issaquah, WA. She is author of Undulation: Relieve Stiffness and Feel Young Again, which teaches a fun and easy exercise that builds balanced strength and flexibility around the spine. For more information or to contact Anita, visit

Jones KD, Adams D, Winters-Stone K, Burckhardt CS. A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988-2005).School of Nursing, Oregon Health & Science University, Portland, Oregon, USA.
Good Living with Fibromyalgia, The Arthritis Foundation, 2006.