Which physical modalities in addition to exercise may be beneficial to patients with fibromyalgia?

Updated: Apr 23, 2020
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Qigong, a traditional Chinese practice that is currently characterized as meditative movement, has demonstrated benefit in fibromyalgia. However, the best outcomes require diligent practice. Four trials in 201 subjects who practiced qigong for 30-45 minutes daily over 6-8 weeks found significant and consistent benefits in pain, sleep, impact, and physical and mental function, with benefits maintained at 4-6 months. [126]

Tai chi resulted in greater improvement in fibromyalgia symptom scores than did aerobic exercise, in a randomized controlled trial by Wang et al in 226 patients. Patients randomized to tai chi were enrolled in one of four regimens: supervised sessions once or twice weekly for 12 or 24 weeks. Aerobic exercise comprised supervised sessions twice weekly for 24 weeks. Participants were also advised to perform tai chi or aerobic exercise on their own for 30 minutes daily. [127]

At 24 weeks, the change in fibromyalgia severity score was significantly greater in the four tai chi groups combined than in the aerobic exercise group, but the difference was not clinically meaningful. However, tai chi twice weekly for 24 weeks provided substantial clinical benefit compared with aerobic exercise. [127]

Heat, massage, and other treatments are useful. Diffuse and regional pain is improved by strategies such as saunas, hot baths and showers, hot mud, and massage. However, excessive dependence on administration of physical therapy and modalities by another person may confound the patient's efforts to achieve self-efficacy for pain control.

Encouragement and positive reinforcement can improve compliance. Obesity, poor posture, and overloading activities at work and at home should be addressed.

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