Review Exercise and pharmacologic management of fibromyalgia 2026 Young et al

[Andy]

Fibromyalgia is a multifactorial chronic pain syndrome that can be bewildering and frustrating; it is rewarding for both patients and physicians to manage it well. Fibromyalgia affects approximately 2% to 4% of the population. While older research suggested the ratio of women to men affected is about 7 to 1, it is likely much lower due to evolving diagnostic criteria.1 This article aims to briefly review the evidence for nonpharmacologic and pharmacologic management of this condition.

Open access

 

[Andy]

A letter in response to this.

Exercise may cause harm in subset of fibromyalgia patients, 2026, Tabassum et al

"As noted in the article, there is limited high-quality evidence supporting exercise in fibromyalgia, with only modest benefits observed in some patients. These recommendations persist not only for potential symptom improvement, but also for broader health benefits including reduced cardiovascular risk and improvements in mood and musculoskeletal health. The article concludes that exercise offers modest benefit without evidence of harm; however, a direct reference for this statement does not appear to be provided.

An important consideration not addressed in the article or the Canadian fibromyalgia guidelines is the impact of exercise recommendations on fibromyalgia patients with comorbid myalgic encephalomyelitis–chronic fatigue syndrome (ME-CFS), hereafter referred to as ME."

Open access

 

[Utsikt]

Are they just parroting what’s being said in the «systemic reviews»? That seems like a surefire way to include all kinds of biased results because the average quality assessment is dire.

 

[shak8]

My personal FM experience with exercise is this:

yes, to the cardiovascular and recreational benefits (being outdoors, accomplishing a task-dopamine release), but as for improvement of pain--no, not at all.

You have to keep the activity from increasing pain and fatigue more than 5-10% the next day. This self-monitoring is difficult.

The problem is that the official prescription for and incessant exhortation to "exercise, exercise, exercise" in FM is manipulative propaganda which is hard to ignore by the FM person, as all your life you've been coached to be active.

And now in illness it feels almost criminal not to obey the drumbeat of physicians with their cheat-sheets for FM "treatment."