Exercise for fibromyalgia pain and fatigue
Find out how you can use exercise to gain strength and energy and better manage your symptoms.









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Physical activity can be tough when you have fibromyalgia. It may be difficult to exercise on the days you're feeling fatigued. And on days when you're feeling well, you may be tempted to overdo it. But exercise is important, even if it's just a little. That’s because being inactive is likely to make your symptoms worse.
While many scientists agree that exercise may help relieve fibromyalgia symptoms, they’re not yet certain about why it works. There’s likely no single reason, but many reasons working together. In fact, a 2023 review published in Therapeutic Advances in Musculoskeletal Disease found 29 different plausible reasons. Among them:
Exercise improves sleep, relaxes muscles, and activates the body’s natural pain-relief system.
When muscles are exercised, they get more oxygen, which can lower pain sensitivity.
Some exercises may activate the immune system, the endocrine system, and the autonomic system, and may improve mental health.
There are no one-size-fits-all exercise guidelines, and strenuous activity may aggravate your fibromyalgia. But with a bit of trial and error—and guidance from your healthcare provider (HCP)—you can find activities that make sense for you.
Sources: Neelapala YVR + 8
- Neelapala YVR, Mercuri D, Macedo L, et al. Mechanisms hypothesized for pain-relieving effects of exercise in fibromyalgia: a scoping review. Ther Adv Musculoskelet Dis. 2023 Jul 16;15:1759720X231182894.
- Rodríguez-Huguet M, Ayala-Martínez C, Góngora-Rodríguez P, et al. Aquatic Exercise in Physical Therapy Treatment for Fibromyalgia: Systematic Review. Healthcare (Basel). 2024 Mar 21;12(6):701.
- Bilodeau, Kelly. “Fibromyalgia: Exercise helps — here’s how to start.” Harvard Health Publishing. October 13, 2020.
- Zhang KD, Wang LY, Zhang ZH, et al. Effect of Exercise Interventions on Health-Related Quality of Life in Patients with Fibromyalgia Syndrome: A Systematic Review and Network Meta-Analysis. J Pain Res. 2022 Nov 22;15:3639-3656.
- López-Gómez I, Velasco L, Gutiérrez L, et al. Symptoms in women with fibromyalgia after performing physical activity: the role of pain catastrophizing and disease impact. Clin Rheumatol. 2023 Jan;42(1):225-232.
- Antunes MD, Marques AP. The role of physiotherapy in fibromyalgia: Current and future perspectives. Front Physiol. 2022 Aug 16;13:968292.
- U.S. Department of Veterans Affairs – Whole Health Library. Tai Chi and Qi Gong. Page last updated May 1, 2024.
- Du M, Hou X, Lu S, et al. Effectiveness of traditional Chinese exercise in patients with fibromyalgia syndrome: A systematic review and meta-analysis of randomized clinical trials. Int J Rheum Dis. 2023 Dec;26(12):2380-2389.
- Mayo Clinic. Fibromyalgia. Page last reviewed October 26, 2021.