Study: Tai Chi May Help Fibromyalgia

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Tai chi may improve pain and other symptoms of fibromyalgia, a small study suggests. Fibromyalgia symptoms include fatigue, body pain and tenderness in joints and muscles. They also vary from person to person. The cause is unknown. The study included 66 fibromyalgia patients. They were randomly assigned to one of two programs. One group did tai chi, a program of slow movements, meditation, deep breathing and relaxation. The other group received wellness education and did stretching exercises. Sessions occurred twice a week for 12 weeks. By the end, symptoms had improved for people who did tai chi. In questionnaires, they reported less pain. They also said they had better mood, sleep, exercise capacity and quality of life. There was little change for the other group. Improvements remained 12 weeks after the program ended. The New England Journal of Medicine published the study August 19.

What Is the Doctor's Reaction?

Fibromyalgia is a poorly understood disorder that causes widespread pain in muscles, joints and the spine. Other symptoms include:

• Marked soreness when certain spots on the body (called "tender points") are pressed


• Poor sleep quality


• Fatigue and low energy level


• Headaches


• Difficulty concentrating

Fibromyalgia is common, affecting up to 5% of the population. Women are much more likely to have it than men. Symptoms usually begin between the ages of 35 and 50.

Many diseases can have the same symptoms as fibromyalgia. There is no blood test, imaging test or other procedure to diagnose it.

Fibromyalgia therefore is a diagnosis of exclusion. This means you and your doctor must consider other reasons for your symptoms. Several conditions can mimic the features of fibromyalgia. They include:

• Underactive thyroid (hypothyroidism)


• Vitamin D deficiency, causing the bone disease osteomalacia


• Rheumatoid arthritis


• Sleep apnea

Treating fibromyalgia is just as challenging as diagnosing it. It's not from a lack of medicines. In fact, there are many medicines people with fibromyalgia can try. But most of them give only partial relief. Often the side effects are worse than the fibromyalgia symptoms.

It's easy to understand the frustration that people with fibromyalgia feel. Their doctors often share this feeling. Patients understandably may perceive their doctor's frustration as skepticism about how bad they actually feel.

It's no surprise that people with fibromyalgia often turn to alternative therapies. However, few studies have been done on how well these therapies work for fibromyalgia. Most of the studies show mixed results at best.

Now researchers are reporting on a well designed study of tai chi (ty-CHEE') in people with fibromyalgia. Results appear in today's issue of the New England Journal of Medicine. One-half of the patients practiced tai chi under the direction of a tai chi master. The other half (the control group) received wellness education and stretching exercises.

Tai chi is a gentle exercise routine. It includes slow movements along with deep breathing and mental focus. Through these movements, your body learns how to remain stable and upright while shifting weight.

Those who did tai chi had less pain than those in the other group. They reported more improvement in mood. And they also had a greater boost to their quality of life, including sleep and exercise.

What Changes Can I Make Now?

If you are like many people with fibromyalgia, you probably feel that any type of exercise is too difficult. But exercise may be more effective than medicine. You need to start slowly. Then you can gradually increase how long and how intensely you exercise. The gentle and mindful exercise routine of tai chi seems to fit this description perfectly.

There are no significant side effects. At first, you might feel even more exhausted and probably will be sore. But this should ease as you continue with the routine. You will need instruction and guidance from an experienced tai chi practitioner.

The reasons that tai chi was effective in this study are not clear. Stress reduction may play a major role, since stress can increase sensitivity to pain. If tai chi is not right for you, other therapies also can help to relieve stress. They include:

• Yoga


• Massage therapy


• Biofeedback


• Individual or group therapy for stress management

Any of these therapies can be combined with medicine.

There is no single best drug treatment. In fact, it's hard to predict which, if any, medicine will help the most. Here are some common treatments.

• Pain relievers -- These include acetaminophen (Tylenol and others), aspirin, a nonsteroidal anti-inflammatory drug (ibuprofen, naproxen and others) and tramadol (Ultram).


• Antidepressants – Examples include amitriptyline (Elavil), fluoxetine (Prozac) and duloxetine (Cymbalta).


• Muscle relaxants -- These include cyclobenzaprine (Flexeril) and tizanidine (Zanaflex).


• Newer medicines approved to treat fibromyalgia -- These include pregabalin (Lyrica) and milnacipran (Savella).

What Can I Expect Looking to the Future?

It's hard to design studies of alternative therapies that meet Western standards. That's why this study of tai chi to treat fibromyalgia is so impressive. Despite the limitations, the National Institutes of Health (NIH) encourages researchers to submit funding proposals for these types of studies.