There are more questions than answers when it comes to fibromyalgia, or chronic pain. What doctors know is that it causes muscle pain throughout the body, fatigue, sleep problems and even psychological impairment and depression. What they don’t know is what causes it and how best to treat its generalized symptoms.
In a new study published in the BMJ, researchers report encouraging results involving one way to reduce the painful effects of fibromyalgia: with tai chi, an ancient practice originating in martial arts that has since become part of traditional Chinese medicine. The mind-body practice involves both physical and psychological exercises that promote health. While small studies have suggested that tai chi could help reduce symptoms of fibromyalgia, no rigorous trial has compared tai chi’s effect to those of currently recommended treatments for the condition, until now.
In the new study, scientists led by Dr. Chenchen Wang, director of the Center for Complementary and Integrative Medicine at Tufts Medical Center, and her colleagues studied a group of 226 people with fibromyalgia for a year. For the first 12 to 24 weeks, they randomly assigned the volunteers to a currently recommended aerobic exercise regimen, or one of four tai chi sessions. They measured people’s symptoms of physical pain and psychological effects of their condition at the start of the study and again at 12, 24 and 52 weeks.
Wang found that while all of the people reported fewer symptoms at the end of the year, all those in the tai chi groups reported more improvement in their symptom control than people in the aerobic exercise group after 24 weeks. And among those assigned to a tai chi regimen, people who practiced tai chi for a longer period of time showed greater improvement than those who did it for a shorter period.
“We think our results suggest that physicians should think about what type of exercise is best for their patients with fibromyalgia,” says Wang. “We found that tai chi was more enjoyable [for patients], there was a social connection and they could practice it at home by themselves with their family and friends.”
Wang measured a variety of things related to fibromyalgia, including the intensity of pain, people’s ability to function, fatigue, how tired they felt in the morning, whether they were depressed, how well they could perform their job and how well they slept. Regardless of which exercise group they were assigned to, all of the people in the study continued to take whatever medications they were using, and over the year started to reduce the amount of pain killers, antidepressants, muscle relaxants and other drugs they were taking. The study did not involve enough people to determine if the tai chi groups showed greater reduction in their medication use than people in the aerobic exercise group, however.
While it’s not clear what causes chronic pain, doctors believe that being physically active can improve blood flow to the brain and body and may relieve a variety of symptoms, from depression to pain caused by inactive muscles and joints.
Wang says that tai chi may therefore be particularly useful for people with chronic pain, since it involves both the mind and body. People are taught to include meditative and relaxation skills in their movements. Many people with chronic pain are also not able to exercise due to their physical or psychological symptoms; some who start aerobic type exercises often stop. Indeed, those assigned to the tai chi classes in the study attended 62% of them, while people assigned to aerobic exercise attended 40% of their classes.
Wang says that doctors should consider tai chi as a possible treatment for people with fibromyalgia, especially since it appears to be easier to start and maintain. And if the improvements reported in the study are confirmed, more people with the condition may be able to improve their quality of life.
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