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Even Mild Exercise Can Reduce Pain

Posted: May 29, 2009

You want to exercise, but you're afraid that the amount of exercise your doctor tells you to do might throw you into a flare. On the other hand, you want to keep your strength up to continue with your daily activities and responsibilities. Besides, exercise is not only good for your heart and other muscles, but also for your self-esteem and overall well-being.

A study presented at this year's America Pain Society (APS) meeting by Dane B. Cook, Ph.D., of the University of Wisconsin, in Madison demonstrates that you might not have to work as hard as you think to benefit from an exercise program.*

Cook noted that the APS recommends moderately intense aerobic exercise two to three times a week to help manage fibromyalgia pain. But the words "aerobic" and "intense" are scary, and patients often wonder if they'll be paying the price with more pain later.

"The guidelines for a chronic pain management exercise training program may be considered unmanageable or too intense for some fibromyalgia patients," says Cook. "Research suggests that adherence rates to high-intensity exercise are lower compared to low-intensity exercise programs."

For the study, 21 women with fibromyalgia (averaging 44 years of age) rode a stationary bike for 20 minutes on two separate occasions, each at a different level of intensity. Before and after the rides, all of the women were asked to rate their pain and their pain threshold levels were measured.

In one of the sessions, the women were allowed to ride the bike however hard they wanted. They could decrease or increase the pedal resistance (ease of pedaling) of the ride as long as they maintained the preset cycling speed.

On the other bike ride, the women were required to exert a "prescribed" amount of energy that maintained their heart rate at an predetermined intensity for the individual based on their maximum heart rate, weight, age, etc. In other words, the pedal resistance made them work harder (like going uphill) to maintain the preset speed over the 20-minute workout.

Every five minutes during the tests, all the women recorded how much they felt they were exerting themselves and how much muscle pain they were experiencing. In addition, the researchers kept track of their heart rate and the amount of energy they expended.

Needless to say, when the women were riding the bike at their chosen level of intensity they felt like it was easier, they actually recorded using less energy, and their heart rates also were lower than when they rode at the required settings. Overall, the women preferred the lower-intensity ride compared to the prescribed ride.

Surprisingly, the amount of muscle pain experienced by the women was significantly lower during and after both style rides, even up to four days. So it really didn't matter how hard the women rode the bike, because even the easier, self-paced exercise was equally effective at reducing the pain.

While these results are somewhat contrary to previous findings, Cook says, "The preferred exertion (self-paced) model could be promoted as an appropriate and more generalized strategy to reduce pain in patients with fibromyalgia, especially since the pain and other debilitating symptoms are highly variable."

* Newcomb L, et al. J Pain 10(4):S16, Abstract 163, 2009.

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