Warm Water Exercise for Fibromyalgia

When you have fibromyalgia (FMS), exercise is a double-edged sword—it can make you feel better, but it can also make you feel worse.

How's that possible? It's all about intensity and duration. Both of them have to be tailored to your individual level of exercise tolerance.

A form of exercise for fibromyalgia that's had a lot of attention is warm-water exercise. Numerous studies have shown that it offers a lot of benefits. Researchers say it can help:

• improve pain threshold (the point at which sensation becomes painful)
• reduce tender-point counts
• reduce pain
• boost cognitive function
• improve functional capacity
• improve mental health
• decrease body fat
• make you perceive your condition as less severe

Studies also show that people with FMS are able to tolerate warm-water exercise better than some other forms of exercise.

How Strong Is the Evidence?

Of course, whenever you're talking about research, you have to take into consideration how reliable the studies are.

A 2014 review of evidence published in Cochrane Database of Systematic Reviews concluded that there was low-to-moderate quality evidence that aquatic training is beneficial for fibromyalgia. It also found very-low-to-low quality evidence supporting a combination of water and land-based exercise.

This level of evidence isn't that unusual when it comes to studies of non-drug treatments. However, it does indicate that your results may not be in line with study conclusions.

You may have extenuating factors that make exercise therapy less successful as well, especially when it comes to overlapping conditions.

• If you have chronic fatigue syndrome, which is common in us, the symptom of post-exertional malaise may make you far less able to tolerate exertion and lead to severe upswings in symptoms.
• If you're seriously deconditioned, you may need to exercise far less than people in the studies.
• If you have overlapping conditions that include joint damage, such as arthritis, you may need a program specifically tailored to you and not just to fibromyalgia patients in general.

Still, the consistency of positive findings lends some credibility to the body of evidence. You should consider the pros and cons carefully and discuss them with your healthcare provider(s) before jumping into an exercise therapy of any kind.

General Benefits

Water exercise, in general, is easier to perform and more beneficial than the same exercise on land, plus it's gentler on your body. It has several benefits for us.

• It's non-impact, so it won't jar your muscles and joints.
• The buoyancy decreases the effects of gravity so moving takes less effort.
• Water provides resistance, which helps you build strength and develop better balance.
• Immersion in water helps you relax and lowers pain perception.

Why Warm Water?

A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.

If you tolerate cold well and don't feel your muscles tense in a regular-temperature pool, you can try exercising there. However, watch for signs that your body is reacting poorly to the cold, both during and after your work out.

Most gyms do not have therapeutically warm pools. Your healthcare provider or physical therapist may know of some in your community, or you can check with local agencies and institutions, including:

• colleges & universities
• YMCA or YWCA
• rehabilitation centers
• The Arthritis Foundation
• Easter Seals
• The Salvation Army
• support groups for arthritis or FMS

Many of these places have scheduled classes for people with FMS or with any condition that limits mobility, where you can learn from a qualified instructor.

Getting Started

Check with your healthcare provider before beginning aquatic therapy or any exercise program.

• Look for a qualified instructor or therapist.
• Start slowly, with short, low-intensity sessions and then work up gradually.
• Start with 2 sessions a week, several days apart, to see how your body responds to the exercise.
• Know your limitations and stay within them. Don't feel like you have to make it through an entire class.
• Don't try to push through the pain, as it will likely make you hurt much worse later on.
• Talk to your healthcare provider about the timing of any painkillers you are on. If you take them before exercising, you may miss your body's cues that you're working too hard.