I have fibromyalgia and every time I try to exercise, my symptoms get worse. I know exercise is supposed to be helpful. Why does this happen? What am I doing wrong?

Fibromyalgia syndrome (FMS) is a poorly understood condition that causes widespread muscle pain and fatigue along with many other symptoms. Symptoms are often made worse by too much physical activity, including overstretching.

Exercise does seem to help patients with FMS. Studies show that people with FMS who are aerobically fit have fewer symptoms than those who are deconditioned.

Real-time ultrasound has shown that blood circulation to the affected areas is often greatly decreased while at rest. During exercise, when circulation should normally increase to the muscles just the opposite happens. Circulation is decreased even more.

In general, the level of muscular activity in fibromyalgia is high, even when the body is sitting or reclining. During daily activities such as cleaning or cooking, the muscles used for these activities are at a higher level of activity than the muscles of a normal person doing the same tasks.

When the activity is over and the person with FMS is resting, those same muscles continue to repeat the activity over and over. This occurs at a lower intensity so no there's no outward movement.

What can you do to avoid increased symptoms with exercise? First, expect some amount of increase in pain, soreness, and stiffness. This may last a few weeks. It should be tolerable. Try to keep going. Start out slow but steady. Increase the duration and intensity of exercise by small amounts day by day or week by week.

A pool therapy program or aquatics class may be the best way to get started. The warm water supports the body and may help improve blood flow to the muscles. The key is to begin with a level of exercise you can tolerate and go from there. If you miss several days in a row, back off to a prior level of intensity. Slowly build up again.