In a recent issue of the Johns Hopkins Arthritis Bulletin, Dr. Kevin R. Fontaine, Assistant Professor of Medicine in the Division of Rheumatology at Johns Hopkins University, talked about non-pharmacological treatments for fibromyalgia. Here’s an excerpt.

Although fibromyalgia syndrome is not curable and has no blood tests to detect it, there are a variety of non-pharmacological treatments that can help relieve symptoms. Following are several questions I am frequently asked about complementary fibromyalgia treatments, and my answers.

Q. How important is it for a person with fibromyalgia to take a majority stake in their improvement?

A. People with fibromyalgia have to understand that, in most cases, they're not going to be able to take a pill that’s going to give them tremendous relief. Rather, it’s up to them to stretch, to exercise, to walk, to try to reduce stress in their lives, to seek counsel for anything that’s going to relieve stress or family issues. A willingness to be proactive and to learn ways to take better control over their symptoms is a critical factor in managing fibromyalgia.

Q. How is fibromyalgia treated?

A. Despite the lack of a definitive cause, fibromyalgia symptoms can be significantly improved with a multifaceted approach. There are two major goals:

• Lessen pain and fatigue
• Improve sleep

Much of the success of fibromyalgia treatment lies with the patient, and many people report feeling better simply because a diagnosis has been made. It is reassuring for people to know that the disorder is not deforming or life threatening, and that they will be able to take steps to help better control their symptoms.

Q. What role does physical activity play in fibromyalgia treatment?

A. Getting up and moving is the key to improving fibromyalgia. A lack of physical activity worsens fibromyalgia symptoms because unconditioned muscles are more sensitive to pain. Although activity and exercise may be the last thing people with fibromyalgia want to do when they feel achy and tired, studies have shown that fibromyalgia symptoms improve after six to eight weeks of moderate aerobic exercise. It’s thought that aerobic activities such as walking, swimming, and bicycling raise the pain threshold and increase pain tolerance, along with physical stamina.

At Johns Hopkins, we encourage our fibromyalgia patients to explore different ways to become active and find what works best for them. It is important not to overdo activity, however. Start slowly, with perhaps 5 to 10 minutes of brisk walking a day, for example. As you begin to feel better, gradually increase the time of the exercise session until you are up to 30 to 40 minutes of aerobic activity at least three times a week. People whose pain is exacerbated by the jarring movements of weight-bearing exercise (such as walking or jogging) may try swimming or riding a stationary bicycle instead.