Elevation of cytokines in fibromyalgia, including IL-8, provides evidence in support of an inflammatory hypothesis.
With exercise, the level of circulating markers of inflammation, including IL-8, are shown to decrease in fibromyalgia. It is well established that exercise reduces inflammation generally. Fibromyalgia symptom response to exercise is consistent with, and supports, the inflammatory hypothesis in fibromyalgia.
It has been shown that exercise of low to moderate intensity is substantially more beneficial in fibromyalgia than is high intensity exercise. In fact, aerobic exercise of low to moderate intensity, three times per week, was found to increase dramatically the patient’s overall sense of well-being, by up to 7 points on a 10 point scale. Pain was also reduced by an average of 1.3 points on a 10 point scale, and tender points were found to be less sensitive to pain as measured by the pressure threshold.
Strength training programs have also been employed with some success in the treatment of fibromyalgia. An increase in the overall sense of well being of 41 points on a scale of 100 was reported in one study, which was accompanied by an average 50% decrease in pain.
Exercise in fibromyalgia and related inflammatory disorders: known effects and unknown chances.
Summary of the Abstract
Current hypotheses on the etiology of fibromyalgia include both neuroendocrine and inflammatory models.
Fibromyalgia patients have been shown to benefit from exercise, though the mechanism by which symptom relief has been obtained by exercise remains unknown.
A pilot study was conducted on a group of 14 subjects with a confirmed diagnosis of fibromyalgia. Each individual participated in an aquatic exercise program of one hour duration, three times weekly, for four months.
Prior to the start of the exercise program, circulating markers of inflammation were measured. The fibromyalgia patients had higher circulating levels of IL-8, IFN, CRP and cortisol than did healthy controls.
At the conclusion of the exercise program, a significant decrease in the concentrations of IL-8, IFN and CRP were noted.
These results support the hypothesis that fibromyalgia is characterized by inflammation and suggests that the benefit of exercise in fibromyalgia occurs as a result of the anti-inflammatory effect of exercise.