While the true causes of fibromyalgia are still unknown, it is thought to be a neurologic disorder. Fibromyalgia causes widespread pain throughout the body and exhaustion. Specific treatments are lacking, and conventional therapy typically involves a combination of several medications with multiple potential side effects. Pilates offers a complementary or alternative approach to relieving some of the most troubling symptoms of fibromyalgia.

Why Use Pilates for Fibromyalgia?
Conventional treatment for fibromyalgia involves multiple medications to treat specific symptoms: analgesics for pain, antidepressants to improve mood, muscle relaxants, and short-term sleep aids. Pregabalin (Lyrica) is the first drug specifically approved by the FDA to treat fibromyalgia. About half the time it may reduce pain and improve function. However, the side effects are multiple: dizziness, sleepiness, difficulty concentrating, blurred vision, weight gain, dry mouth, and swelling in the hands and feet. In other words, Pregabalin may aggravate many fibromyalgia symptoms, while helping others. Other medications similarly have both mild and serious side effects that can be concerning.
Pilates is a non-invasive intervention that can be beneficial as a substitute for or complement to drug interventions. Pilates is minimal-impact to no-impact exercise and can be individualized to accommodate specific painful symptoms and physical limitations. Pilates improves awareness and functioning of the torso, which enables a client to perform the activities of daily living, such as bending, lifting, sitting, rising, reaching, and many others. It is especially appropriate for maintaining or restoring range of motion and function following underuse or misuse of a joint due to fibromyalgia symptoms.
Pilates also improves proprioception, the body’s awareness of its place and movement in space. On a practical level, for an individual limited by fibromyalgia symptoms, this means training the body to better and more efficiently respond to changes, such as regaining or maintaining balance on uneven ground to reduce falls. Increased adaptability and coordination can help decrease the chance of injury from accidents or improper overuse in a particular body movement.
As flexibility, strength, and functional improvements are made, incorporating other forms of fitness such as cardiovascular exercise becomes safer and easier. Complementing a Pilates program with a cardiovascular regimen can be very beneficial to the overall health and quality of life of a person with fibromyalgia.
Overall, Pilates can be a complementary approach to a holistic treatment plan involving medications, cognitive or other psychological therapy, lifestyle modifications (stress reduction, adequate sleep, regular exercise, healthy diet), and other alternative practices (biofeedback, acupuncture, massage therapy, chiropractic, and osteopathic care).
How Can Pilates Help Relieve Fibromyalgia?
Pilates can help maintain quality of life and the ability to perform daily activities of fibromyalgia suffers through improvements in flexibility, strength and tone, functional use of joints, and body awareness. Specific Pilates movements incorporate safe stretching with resistance work to help improve flexibility and reduce the chance of injury to tight muscles. It increases muscle strength and tone without increasing bulk. Improvements in strength and flexibility can also improve the functional and proper use of joints. Pilates is as much a practice in mind-body awareness as a resistance and endurance training method. Being aware of how one moves and where the joints and limbs are in space improves coordination and balance. As with many forms of exercise, the physical activity of Pilates can also help improve mood and energy levels.
Incorporating Pilates equipment into an exercise plan can be particularly beneficial for those who are at risk for injury or who experience chronic pain, a common problem for individuals affected by fibromyalgia. The Reformer is a supine table that allows for the shoulders and feet to be fixed. The springs can increase resistance or provide assistance through a movement. Performing exercises in this position also avoids the jarring and joint compression that accompanies exercising in standing or other unsupported positions. Another piece of equipment called the Cadillac allows the instructor to guide the client in working one area without engaging another. For example, if muscles are particularly painful and tender in the legs, this equipment can allow for upper-body resistance work as well as supported lower-extremity rehabilitation work.
Prior to beginning any fitness program, it is important to consult a physician. A Pilates instructor will review a potential client’s medical history, current medications, and doctor recommendations for accommodating any health conditions, such as fibromyalgia. While safe for almost anyone at nearly every level of fitness, there are certain conditions or symptoms that must be accommodated or might even be a contraindication to Pilates participation. The instructor will also conduct a fitness assessment that includes measuring the client’s flexibility and strength as well as assessing balance, joint range of motion, posture, and gait. Communicating fitness goals and expectations to the instructor will help him or her to design a safe, fun, and challenging individual program that can help overcome the symptoms of fibromyalgia.
What is Pilates?
Pilates (puh-LA-teez) is a form of mind-body exercise and movement that uses resistance training and balance to improve strength, endurance, and flexibility in the muscle groups of the abdomen, pelvis, and spine, known as the core. The practice uses deep breathing to increase lung capacity and circulation. Pilates can help locate specific weaknesses while protecting vulnerable joints or injuries, especially important with fibromyalgia.
German-born Joseph Pilates developed Pilates while he was interned in England during World War I. Using bed springs and other parts he created resistance training equipment for his fellow internees. He came to the United States in 1926 and opened a studio in the same building as the New York City Ballet. George Balanchine became a major supporter and invited Pilates to instruct his young ballerinas. After many years as a favorite training method for dancers and athletes, Pilates has over the past decade become a part of the workouts in gyms and fitness centers across the country and the recipient of numerous celebrity endorsements.
What Is Fibromyalgia?
Fibromyalgia is thought to be a neurologic condition that causes generalized and widespread muscle, tendon, and ligament pain with tender spots. People with fibromyalgia typically have incapacitating fatigue and exhaustion, sleep disturbances, as well as heightened sensitivity to temperature, touch, odors, bright lights, and loud noises. Other symptoms may include muscle stiffness, chronic headaches, facial pain, TMJ, dry mouth, eye and nose dryness, irritable bowel syndrome (IBS), incontinence, abdominal pain, painful menstrual cramps, poor hand and foot circulation (Raynaud’s phenomenon), tingling in the hands and feet, and restless leg syndrome. Understandably, these symptoms may lead to or exacerbate anxiety, depression, insomnia, fatigue upon rising, and difficulty concentrating. Fibromyalgia is more common in women than men, but it is not progressive or life-threatening.
There is no definitive test for fibromyalgia. Doctors use what is called a “diagnosis of exclusion,” meaning that when similar conditions are eliminated as possibilities (such as osteoarthritis, bursitis, tendonitis), fibromyalgia may be diagnosed. While the exact cause or causes of fibromyalgia are unknown, the condition is thought to be the result of changes in the central nervous system that affect the way sensory input (such as touch, pain, temperature, sound, and smell) is processed. Contributing risk factors could be infection, injury, hormonal changes, stress, sleep disturbances, genetic factors (having a family history of fibromyalgia), having a rheumatic disease (such a lupus or rheumatoid arthritis), changes in the way muscles make and use energy, or abnormalities in the involuntary nervous system.
Finding a Pilates Instructor
Look for a Pilates instructor experienced in helping people with pain. It is important to inquire about an instructor’s specific expertise in the area of fibromyalgia or other chronic pain and fatigue syndromes.