Managing Fibromyalgia

By Timothy McCall, M.D.  |  

As sufferers of the condition well know, there is no definitive test to diagnose fibromyalgia syndrome (FMS). A disorder marked by debilitating fatigue and pain, its cause is still largely a mystery. However, increasingly strong scientific evidence suggests a physiological basis for the condition. It has been shown, for example, that people with FMS have elevated levels of a substance in their spinal fluid (substance P) that may amplify pain signals going to the brain. And a study published in the Journal of Medical Virology in December 2003 found that a chronic viral infection appeared in the muscles of some FMS patients.

Even so, some physicians still believe that fibromyalgia doesn’t exist; instead, they attribute symptoms such as severe pain, muscle tenderness, fatigue, and sleep troubles to a psychiatric problem. This misconception does little to help sufferers, and can leave them feeling demoralized and discouraged.

Fortunately, yoga can provide two invaluable things to people with fibromyalgia: relief from symptoms and hope. Though it isn’t a cure, yoga can offer a better quality of life. A 1999 study led by Patrick Randolph, Ph.D., at Texas Tech University’s Health Sciences Center found that a program of gentle yoga stretches and mindfulness meditation reduced pain and improved patients’ ability to cope with it. Here’s what I suggest for a yogic approach to managing FMS.

Try not to overdo it. Symptoms can vary widely from day to day, and on a good day, it can be tempting to practice vigorously. While physical activity can be very helpful, it’s important to begin slowly and progress gradually to avoid a flare-up of symptoms. If you’re particularly tired one day, stick with restorative poses, such as Viparita Karani (Legs-up-the-Wall Pose) and seated forward bends with a bolster.

Learn when to work through pain. Much of the pain caused by fibromyalgia appears to be due to inappropriately amplified nerve signals, so even though an asana might feel slightly painful, you’re probably not damaging your muscles or connective tissue. It’s important, however, to differentiate between the dull discomfort that comes from stretching tight muscles, which is safe to work with, and the sharper pain that comes from compressing a joint or straining a ligament. If you feel the latter type of pain, come out of the pose right away.

Keep a journal. Write down how your asana practice makes you feel from day to day. Do you have less pain than usual the day after? If you practice regularly, does your mood improve? How about your sleep? These observations may be more reliable indicators of whether the practice is helping you than how you feel while doing the poses.

Try a diverse approach. In addition to asana, try Pranayama, chanting, and guided imagery. Regular meditation can teach you to modulate the pain and quiet the internal chatter that can heap mental suffering on top of physical discomfort. And experiment with Western medicine as well as acupuncture, massage, and other forms of bodywork. (Choose a practitioner who has experience treating people with FMS.)

Find a community. The love and support of a community can be therapeutic. Try the Fibromyalgia Network at (800) 853-2929 or visit The network publishes a newsletter and provides educational materials.

Timothy McCall is Yoga Journal’s medical editor. To suggest story ideas for future columns, e-mail You can also find him through his Web site,