The Benefits of Pilates for Fibromyalgia

Pilates is a form of exercise that has become extremely popular in recent years, in large part because it's adaptable to various levels of fitness. It also offers a gentle, no-impact, complete body workout that you can easily do at home. It combines stretching and strengthening exercises through controlled and precise motions with the goal of toning the entire body.

All of those factors make Pilates a possibly beneficial type of exercise for people with fibromyalgia (FMS) or chronic fatigue syndrome (CFS or ME/CFS)—but only for those who can tolerate the appropriate level of exertion. Pilates comes highly recommended by many experts on these conditions, including the National Fibromyalgia Association.

Women using exercise ball
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Pilates Basics

Pilates is based on core strength, which means an emphasis on strengthening the muscles in your torso. Strong core muscles help support the rest of your body, easing the strain on your back and limbs. Pilates also works your entire body with the goal of creating longer, leaner muscles.

If you're somewhat active and don't have high levels of stiffness, Pilates could be the next step for you in improving your strength and overall fitness level.

Note: Always start slowly and separate your workouts by a few days, and keep track of any changes in symptoms you noticed during those days off. Also, be sure to talk to your healthcare provider and other members of your health team before you start any kind of exercise regimen.

Both of these conditions involve problems with exertion. In FMS, it can lead to symptom flares. In ME/CFS, it can lead to a major upswing in symptoms called post-exertional malaise. Because of these realities, we have to be especially careful when we exert ourselves in any way. It's important to know your limits and stay within them, only expanding them slowly and carefully when your body is ready.

Some healthcare providers recommend against any exercise for people with ME/CFS. Others say it's beneficial, as long as it's at appropriate levels.

The Research

So far, we have no studies on Pilates for ME/CFS.

We just have one study on this form of exercise for FMS, but numerous studies have shown that exercise can help lessen symptoms of FMS and that strength training is especially beneficial. However, Pilates and strenuous exercise, in general, may not be appropriate for everyone with these illnesses and may do substantial harm to some.

In the single study (Altan), 25 women with FMS took Pilates from a certified trainer. One-hour classes were held three times a week for 12 weeks. A control group of women with FMS did home stretching exercises.

At the end of the 12 weeks, the Pilates group showed significant improvements in pain and overall function compared to the control group, which showed no improvement. Twelve weeks after the study ended, the Pilates group still was functioning better, but the pain had returned.

This seems to confirm other findings that exercise can be beneficial in FMS. It's important to remember that the key isn't necessarily a lot of exercise, but regular exercise that's appropriate for you.

Is Pilates Right for You?

If you haven't been active for a long time, Pilates may not be the place for you to start. FMS and ME/CFS give us special challenges when it comes to exercising, and you need to take those into account before starting any kind of exercise. You're likely to feel more exertion from Pilates than with other frequently recommended forms of exercise, so it could be more likely to lead to flares or post-exertional malaise.

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  • Altan L, et al. Effect of pilates training on people with fibromyalgia syndrome: a pilot study. Archives of physical medicine and rehabilitation. 2009 Dec;90(12):1983-8.

  • Brosseau L, et al. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Strengthening Exercises in the Management of Fibromyalgia: Part 2. Physical Therapy. 2008 Jul;88(7):873-86.

  • Lloyd AR. To exercise or not to exercise in chronic fatigue syndrome? No longer a question. Medical journal of Australia. 2004; 180 (9): 437-438.

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.