Fibromyalgia exercise & diet

George Morris Physio Wigan

Fibromyalgia exercise & diet


Exercise is powerful medicine, but like all medicines you have to get the right type and dosage.

If you’re dealing with FMS, your recovery ability is probably lower.

That means no “beast mode”, no Ironman triathlons, no “pump till you puke” workouts. (Your body will probably kibosh that stuff pretty quickly anyway.)

And you’ll want to avoid anything that “amps you up”, stresses you mentally, and/or activates your “fight-flight” sympathetic nervous system.

Your goal here is happy, easy, relaxed movement that gets the juices flowing, calms the stress response rather than activating it, and makes you feel good, without overly depleting your limited reserves.

For instance:

Moderate aerobic exercise has been shown to alleviate anxiety, depression, poor pain tolerance, poor sleep, elevated inflammation, and decreased mood in FMS patients.

According to one study, progressive exercise three times per week in a support-group setting increased strength and function while decreasing pain and fatigue.

Qigong, yoga, stretching, tai chi, and meditation appear to address FMS by promoting muscle relaxation and deep breathing.

Some guidelines:

Start slow.

Avoid increasing exercise volume by more than 10% in one day.

When possible, go for lower-impact exercise (water workouts, cycling, walking, yoga, bodyweight resistance work).

Prioritize aerobic capacity, focusing your efforts at one or two steps above “easy.”

Take one day off for recovery between the more intense structured workouts.

After a month of consistent aerobic work, start to build in strength training.

Here are some ideas for distributing your weekly exercise patterns.

Try this simple regimen that alternates days:

5-10 minutes warm-up, 20-30 minutes aerobic work, 20-30 minutes strength work.

Normal everyday activities.

Or, mix it up a bit:

Monday: 5-10 minutes warm-up, 20-30 minutes aerobic work

Tuesday: 60 minutes gentle yoga

Wednesday: 5-10 minutes warm-up, 20-30 minutes strength work

Thursday: Normal everyday activities

Friday: 5-10 minutes warm-up, 20-30 minutes aerobic work

Saturday: 5-10 minutes warm-up, 20-30 minutes strength work

Sunday: Normal everyday activities

Be prepared to nix any part of a session if you’re having an FMS flare-up or when your stress level is unusually high. Don’t try to be a hero.


Though we don’t know exactly what causes FMS, we do know that being overweight increases your risk.

Compounds secreted by body fat may cause inflammation — a potential FMS trigger. In one study, women who were overweight or obese were up to 70% more likely to develop the disorder than those with a body mass index in the normal range.

Of course, regardless of weight, making healthy choices is always a good idea.

Start with how you eat: thoughtfully, mindfully, slowly, and in response to real physiological hunger (here’s how to distinguish between real, physical hunger and emotional hunger).

And track any ups and downs in hunger and appetite in your awareness journal.


Prioritize whole foods: Processed ones contain too many needless sugars, fats and additives.

Eat plenty of plants: More plants in the diet means more antioxidants. And more antioxidants might mean less pain (in fact, some research indicates that a vegan diet may offer short-term benefits to FMS victims).

Go organic when possible: This minimizes your consumption of harmful toxins.

Drink water and tea: Try to avoid juices and sodas, which increase your sugar intake.

Avoid caffeine and tobacco: These are associated with sleep problems and increased pain in FMS sufferers, respectively.

Limit alcohol: In a recent study, FMS patients who were moderate drinkers (consuming 3-7 drinks per week) experienced less pain that heavy or non-drinkers.

Eliminate food allergens and intolerances: Obvious, right? But it might be worthwhile to get a work-up (ALCAT‘s a good one) and find out if you have sensitivities you weren’t aware of. Common culprits include wheat, dairy, sugar, caffeine, aspartame, alcohol, and chocolate.

Beware excitotoxins: These are amino acids and brain-stimulating neurotransmitters found in MSG, aspartame and protein-dense foods that may worsen FMS pain, perhaps by increasing cerebrospinal fluid (the stuff in your brain and spine). In certain case studies, eliminating excitotoxins alleviated FMS symptoms, especially in folks who are particularly sensitive to these chemicals.

Don’t overdo sugar: When added sugars make up more than 10% of your total calorie intake, you might experience candida overgrowth (see above).


Certain nutrients may help fight the symptoms of FMS. When possible, try getting them from food first.

If you choose to supplement:

Pick reputable brands, and introduce supplements one at a time.

Always check for interactions with other supplements and medications first.

Here are some options that you may consider.

Probiotics/prebiotics: These bacteria boost the health of your gut, which can influence your whole body. Sources: sauerkraut, kimchi, miso, yogurt, kefir.

Ribose: This simple sugar is involved in energy production, potentially improving problems related to fatigue and sleep. Sources: milk, cheese.

Magnesium: This mineral seems to be low in some folks with FMS; getting enough might help relieve muscle spasms and cramping. Sources: almonds, spinach, cashews, peanuts, beans.

Melatonin: It’s the hormone we produce to make us sleepy; supplementing might help promote natural sleep cycles.

CoQ10: Coenzyme Q10 acts as an antioxidant and may offset dysfunction of mitochondria (cell parts responsible for energy production) noticed in FMS patients. Sources: fish, liver, whole grains.

SAMe: Taking supplements of this naturally-occurring bodily chemical might help with mood and sleep.

Quercetin: This powerful antioxidant might fight FMS symptoms by tamping down on inflammation. Sources: citrus fruits, apples, onions, parsley, tea.

5-HTP: The body converts this naturally-occurring neurotransmitter into serotonin, a hormone that helps regulate mood, appetite, and sleep. Supplements may improve related FMS symptoms.

Carnosine, BCAAs, creatine: These body compounds might help with muscle energy production. Sources: beef, chicken, pork.

Acetyl-L-carnitine: A synthesized amino acid derivative, ALCAR might assist in mitochondrial function.

Turmeric: This delicious spice — found on its own or as an ingredient in curry — might help buffer inflammation.

Ashwaghanda: An exotic herb available in pill form, it may help improve sleep and anxiety.

Valerian, passionflower: These plant-based supplements might facilitate sleep.

Capsaicin/capsicum: Ingested or used topically, this compound that gives many spicy foods their kick might help decrease pain. Sources: chili peppers.

Iodine: Deficiency in this mineral may lead to chronic fatigue. Sources: seaweed, scallops, cod, white beans, lentils, spinach, Jerusalem artichokes, black beans, soybeans, molasses, Lima beans, tofu, liver, meats, clams.

Zinc: Not getting enough can lead to low immunity and brain fog. Sources: mushrooms, spinach, sesame seeds, pumpkin seeds, green peas, baked beans, cashews, peas, whole grains, flounder, oats, oysters, and chicken.

Iron: Low levels of this nutrient, necessary for delivering oxygen throughout the body, is associated with significantly elevated risk of FMS. Sources: egg yolk, liver, dried beans, dried fruit.

Vitamin D: Low levels of D — only available via fortified foods, supplements and natural sunlight, are common in FMS patients. In a 2014 study, vitamin D supplements significantly decreased FMS pain.

Selenium: One study noted low levels of this mineral in FMS sufferers. Sources: Brazil nuts, yellowfin tuna, orange roughy, rockfish, lobster, swordfish, oysters.

Vitamin B1: Deficiency of this vitamin — needed for energy production and brain function — is associated with poor memory, fatigue, irritability and sleep disturbance. Sources: peas, cowpeas, navy beans, black beans, lentils, soybeans, oat bran, asparagus, sesame seeds, pork, liver.

Essential fatty acids: Making sure you get enough, perhaps through supplements, may help with FMS-related nerve pain. Sources: flax, chia, hemp, cold-water fish, grass-fed meat, pastured eggs.

This is, obviously, a long and complex list. Consider getting guidance from a qualified naturopath or nutrition coach who can help you assess your needs, and put together an appropriate plan.

Bodywork and therapeutic touch

Whether you’re healthy or well, these therapies feel amazing, but there’s evidence they can really help FMS patients.

There’s a saying among body workers: “Mechanoreception inhibits nocioception.”

Catchy, right?

In English, it means that therapeutic touch can alleviate pain by competing for the same nerve signals, sort of like jamming up a highway with cars.

Effective bodywork may include:

trigger point therapy

craniosacral therapy


foam rolling

dry needling





Keep it gentle; if bodywork is too intense, it’ll work against your anti-pain efforts.

Again, keep track of what interventions seem to improve your symptoms.

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