The fibromyalgia It’s a disease more often than you thinkalthough there is still some underdiagnosis. According to data from the Spanish Society of Rheumatology, the prevalence in Spain is high and affects 2.45% of the adult population, Specially for middle-aged womenFibromyalgia is a disease characterized by chronic generalized pain that the patient locates in the musculoskeletal systemFor this reason, patients suffering from this pathology have “significant physical limitations as a result of the symptomatic impact,” he tells CuídatePlus. Cristina Maestre Cascales, professor at the Polytechnic University of Madrid and member of the Official College of Graduates in Physical Education and Science in Physical Activity and Sports of the Community of Madrid
The pain and fatigue what people with fibromyalgia feel “are a major barrier to participation in regular activities, every day and if possible even more, in physical sports activities ”. In addition, “Fear of pain restriction of voluntary physical activities ”.
All this makes that “lthe disease is still getting worse more by a sedentary lifestyle that leads to a decrease in physical capacities (low flexibility, aerobic capacity, muscle strength, speed, agility and reduced balance) and an increased risk of disability, ”said the expert.
It is important to point this out fibromyalgia is a disease that has no curealthough there are treatments aimed at relief physical and psychological symptomsAmong them stands out exercise which has become an important ally to improve the health of these patients.
This is a therapeutic tool widely used in these patients with excellent results.”, He assures José Casaña Granell, Director of the Department of Physiotherapy at the University of Valencia and General Secretary of the General Council of Societies of Physiotherapists of Spain
As Maestre points out, these patients cannot only exercise, they have to do it, the question is to determine how much and how.Not everything goes”, He clarifies.Just as a drug is not effective at relieving symptoms, not all physical activity is effective at improving all symptoms of fibromyalgia.For this reason, he advises first of all to go to experts Sciences of Exercise and Sport that they “are the ones who must prescribe physical activity prescriptions to improve each symptom, coordinated with a multidisciplinary team for the optimal management of these symptoms (physiotherapists, doctors, psychologists, nutritionists, etc.)” and this pathology “requires a feedback and feedback process between experts from different fields
It is important that in all sports “treatments”Assess the patient, review their physical limitations and symptoms and his previous experience with physical activity, ”explains Maestre. Based on this, “specific, progressive and gradual exercises are prescribed in frequency, volume and intensity”.
Many advantages
The current evidence “shows that a high degree of physical fitness is associated with a better quality of life in these patients with this diseaseSays Maestre. As Casaña states, “exercising regularly and at the right intensity reduces the impact of fibromyalgia on both the physical and psychological condition of these patients, positively improving their quality of life.”
Exercise in these patients is so important that the recent recommendations of the European League Against Rheumatism (European League against Rheumatism, EULARthey emphasize exercise as the only therapy with high scientific evidence “, as indicated by Maestre.
Like other therapies, therapeutic exercise also has benefits, and there are plenty of them: improves sleep quality, improves physical well-being, reduces pain, increases self-esteem, etc … ”, says Casaña.
For example, according to Maestre, various studies are “have shown that the intensity of pain decreases through aerobic, strength and flexibility programs “Regarding the quality of sleep, this improvement “through a gradual strength training program divided into 3 progressive phases of self-load (with own weight), work with resistance material and external loads”.
In relation to the anxiety, another of the symptoms associated with fibromyalgia, Maestre points out that “several studies have shown that it improves significantly through flexibility programs and joint extension / amplitude, meditative programs, such as Tai Chi, and / or strength programs combined with cognitive behavioral therapies ”.
On fatigue, exercise “could reduce this symptom thanks to progressive strength training of no more than 60% intensity”Adds Maestre.
It’s important to note that fibromyalgia it is a chronic diseaseso that people who suffer from it will live with it all their lives. The good thing about exercise is that helps improve symptoms and may even help spread outbreaks in patientsThe impact of their practice is such that “can help reduce the number of medicationsMaestre says based on his experience with patients suffering from the disease.
In addition, he adds: “Exercise in a group also has a very important and decisive social component in improving psychological symptoms. of this pathology, reducing the dose of drugs such as antidepressants and opiates ”.
Another fundamental benefit of exercise is that it “reduces the impact of outbreaks in number and intensity, a positive aspect for the treatment of the disease.”
Type of exercise
To what kind of exercise is better for these patients, both experts stress the importance of a combination of aerobic and strength exercises, although it cannot be generalized as every person has symptoms. “We cannot design one-size-fits-all recipes for all patients diagnosed with fibromyalgia, as the programs must be designed as a specific outcome, taking into account all the characteristics described above,” Maestre recalls.
According to Casaña, the action lines should be aimed at:
- Strength exercisesThe goal is to achieve muscle strengthening and empowerment. To perform these exercises, patients can use elastic bands, barbells or their own body weight. The program should target large muscle groups and try to reproduce daily movements. The recommended frequency is a minimum of 3 days a week and each exercise should be done between 10-15 repetitions.
- Resistance exercisesThe goal is to reduce the fatigue and fatigue that these patients usually exhibit. These exercises can be done through actions such as dancing, walking or exercises in warm water (temperature between 30 and 35º C).
- Exercises to improve rangeThese exercises can help relax the most contracted muscles. They should be performed through muscle stretches held for 15-25 seconds and a total of 3 to 5 retentions of each stretch. These exercises should be performed very gently and without reaching the limits of the joint range and with a frequency of 3 to 4 days a week.
Less indicated exercises
The benefits of exercise in fibromyalgia patients are many and very different, but there may be instances when it is not recommended.It is true that exercise induces endogenous analgesiaTherefore, some fibromyalgia patients with a dysfunction in the stress response system due to a change in the hypothalamic axis could not benefit from exercise as it could exacerbate their pain and fatigue in the first eight weeks ”. For this reason customization is essential since in these cases “it is recommended to use high variability of programs with different intensities that can be adapted to different clinical profiles”.
It is also important, as Casaña points out: “exclude any pathology that is a contraindication to exercise, and taking into account the pharmacological treatment they follow, since this syndrome, like others, “may occur differently in each patient.”
Therefore “depending on the limitations that the patient presents (pain, fatigue, anxiety, depression …) one or the other type of action will be advisedFor example, in “moderate or severe cases, an exercise program will be established with low intensity and gradual”.
What the experts generally advise against, “sports that involve a lot of training and physical contact and that require maximum intensities to practice,” says Casaña. According to Maestre: “programs with high intensity, more than 80%, are not recommended “In addition, “scientific studies have shown that isometric and eccentric contraction exercises should be avoided, as it can amplify myalgias and, as a result, exacerbate hypersensitivity at the central level,” he concludes.