Activity Not Out of the Question for Chronic Pain

[Guest guest]

Activity Not Out of the Question for People with Chronic Pain

ANN ARBOR, Mich. -- Many people with fibromyalgia and other chronic pain

conditions fear that activity will make their pain worse. But new research

suggests they may be able to be more active than they think – without

suffering from increased pain.

The study by researchers at the University of Michigan Health System and the

Uniformed Services University of the Health Sciences in Bethesda, Md., found

that fibromyalgia patients have similar average activity levels as people

without those conditions. But it also found that their levels of high-intensity

" peak " activities – such as bolting up the staircase, walking for several miles

or taking an aerobics class – are much lower than among people without the

condition.

The first-of-its-kind research – which involved round-the-clock activity

monitoring and analysis rather than relying on patients self-reporting their

activity levels – is helping researchers unlock some of the mysteries of

fibromyalgia. The findings could lead to changes in the treatment of patients

with the chronic condition of pain in the muscles and soft tissue, says Dan

Clauw, M.D., director of the U-M Chronic Pain and Fatigue Research Center

and professor of rheumatology at the U-M Medical School.

" When you ask people with fibromyalgia about their level of function in terms

of activity levels, they'll report a lower function than almost any other

group, "

says Clauw, senior author of the study, which appears in the current issue of

Arthritis & Rheumatism. " The surprising thing that we found was that their

average level of activity was about the same as someone who didn't have

fibromyalgia. "

But researchers found that patients in the study with fibromyalgia, chronic

fatigue syndrome or both spent significantly less time in high-level activities

compared to those without the conditions, the study reports.

The findings suggest that people with fibromyalgia self-report poor physical

function and increased pain after activity because they think in terms of the

most intense activities that cause higher levels of pain. But what they don't

report – and possibly don't realize – is that they can sustain some level of

activity without increased pain.

" We've probably been thinking about fibromyalgia incorrectly, " Clauw says.

" This group was impaired, but they weren't impaired in the way they thought

they would be. This is good news for fibromyalgia patients. "

The study used actigraphs, wristwatch-sized devices that measure

movements in various directions (unlike a pedometer, which just measures

movement in one direction). While previous studies have used actigraphs on

fibromyalgia patients, this is the first study to perform complex, repeated-

measures analyses of the results of ambulatory actigraphy and symptom

reports.

The study involved 38 people with fibromyalgia, chronic fatigue syndrome or

both conditions, and 27 age-matched people without those conditions.

Clauw hopes that the research will provide a new level of understanding of

patients with these conditions. One possible outcome, he says, is a better

insight into how much activity the patients can sustain without increased pain,

based on information from evidence-based research rather than

questionnaires.

" Exercise and activity are essential to the well-being of people with

fibromyalgia, " Clauw says. " Our research shows that higher activity is not in

fact leading people to increased pain, and it could be used to show patients

that they can be active. "

Now, Clauw and his team at the U-M Chronic Pain and Fatigue Research

Center are embarking on more studies of activity, exercise and pain among

people with all kinds of chronic-pain conditions. They've started a registry of

people who would be willing to take part in such studies, both those with

chronic conditions and those without.

For more information on the registry and the studies underway at U-M, visit

www.med.umich.edu/painresearch or call .

The lead author on the paper was Willem J. Kop, Ph.D., of the Uniformed

Services University of the Health Sciences. Other authors were Ali A. Berlin,

M.A., and Cara Olsen, M.S., of the Uniformed Services University; and

Lyden, M.S.; Kirsten Ambrose, M.S.; H. Gracely, Ph.D., A.

, Ph.D, all of the U-M Chronic Pain and Fatigue Research Center.

The research was supported in part by the Department of Army.

Reference: Arthritis & Rheumatism, Vol. 52, No. 1, Jan. 2005, pages 296-303.