Keep on moving: the importance of exercise for fibromyalgia
Since commencing my PhD a few years back and completing my Harvard Clinical Research Course last year I have had the opportunity to assist a leading European rehabilitation journal as a guest peer reviewer. The decision to agree to review a paper is not taken lightly. We reviewers are not able to see the complete submitted paper prior to accepting the offer to review (which is unpaid). We do not know the scientific rigour of research, nor the writing skill of the authors prior to committing to the potentially large amount of time required to complete the review process. The aim of scientific publication is to further the knowledge base of the field and the reviewer is tasked with upskilling to the edge of existing knowledge and then critically reviewing whether the submitted paper is worthy of adding to the body of evidence.

Last week I accepted the offer to review a paper in the field of fibromyalgia, which we see commonly in the clinic. Fibromyalgia is a chronic (long term) disorder that is associated with wide-spread pain and tenderness in the muscles and bones. It often also affects mood, sleep, general well-being, and can be debilitating. I spent considerable time over the last few days reviewing the most current literature and was relieved to find that there is a growing body of evidence supporting the efficacy of EXERCISE for the management of fibromyalgia. Interestingly, there seems be evidence demonstrating that HANDS-ON therapy is NOT efficious (effective) in the management of fibromyalgia.

The following graphic from Courtis’s et al 2015 research demonstrates the current known research on the topic. The forest plot graphic shows the pooled effectiveness of different treatment therapies and the papers that contribute to the pooling. If the back diamond at the bottom of the graph crosses the 0 midline then the pooled effect demonstrates that the particular therapy being investigated currently lacks evidence of effectiveness.

 

The take home message is that although massage and hands-on physiotherapy treatment for fibromyalgia might feel better in the very short term, the best short term and long term strategy is exercise. What type of exercise you might ask?  A type of exercise that falls under the term of Body Awareness Intervention (BAI). Common types of body awareness intervention exercises are yoga, pilates, tai-chi, chi gong or posture and movement classes (click here to learn more about our classes). Whilst it can sometimes be hard to get moving and do exercise when you are feeling tender or in pain I would advise to just start slowly and see how you go from there.

 

+ posts

Larry is a highly skilled physiotherapist who specialises in treating back and neck pain, postural issues and scoliosis. He is certified in Schroth and SEAS methods and through the Egoscue University. Larry has a background in elite gymnastics and springboard diving and also has many years experience in endurance running and triathlons. His specialist knowledge and techniques have seen him appointed as a gymnastics coach and physiotherapist at both the Olympics Games and Special Olympics.

His passion and driving philosophy is about achieving the best outcomes for his patients utilising an amalgam of the latest techniques and theories while recognising there may sometimes be a need for invasive procedures. Where deemed appropriate Larry will then refer to a specialist. To further his holistic understanding and approach, Larry is currently undertaking a Ph.D. in Spinal Deformity and regularly attends and speaks at international conferences and courses and clinics.

Fun fact: Larry is learning how to surf - so be careful next time you go to the beach! Qualifications: B.Sc (Physiotherapy); M.Sc. (Exercise Physiology); Advanced Certificates in Schroth (BSPTS) and Egoscue (PAS) and SEAS Larry is Level II certified (advanced) in the conservative treatment of Scoliosis based on the Schroth method. The training was conducted by Dr Manuel Rigo of the Barcelona School at Scoliosis Rehab Inc in Wisconsin. He has completed his SEAS scoliosis treatment training at ISICO in Milan. Larry has also spent time working with Dr Rigo in the Barcelona clinic. Larry also has advanced certificates in shoulder treatment, posture alignment therapy and acupuncture.