Tai Chi for Fibromyalgia

tc fibro

Tai Chi for Fibromyalgia

People who have fibromyalgia live in considerable amount of pain.  They are aerobically unfit, have poor muscle strength, limited flexibility, and have impaired physical performance.  Studies have shown that exercise would benefit all of those symptoms.   Despite knowing that exercise is beneficial, most people who have fibromyalgia do not participate in a regular exercise program.

Why is it that people who have fibromyalgia do not exercise? It is not because people with fibromyalgia cannot be active, since about 2% of competitive sport players have fibromyalgia.  As a Neurologist the two most common reasons that I hear for the lack of exercise is #1 they are too fatigued and #2 they have too much pain.  (I will talk more about how to treat the fatigue in another post in the future).

People who live with fibromyalgia experience a chronic cycle of pain.  They complain of pain, which causes increased muscle tension, which along with increased stress causes limited activity.  This, then, causes increases fatigue, depression, muscle stiffness, and thus pain.  The best way to break this pain-tension cycle is to start moving.  Unfortunately, patients with fibromyalgia are often reluctant to engage in physical activity due to the fear that the one thing that may help the most may instead exacerbate their pain.

chronic pain_cycle

For this reason I typically recommend people who have fibromyalgia to start with either a warm water-based exercise program or a mind–body forms of exercise such as yoga or Tai Chi. I will discuss  Tai Chi.

Tai Chi is a mind-body practice that originated in China as a gentle form of martial arts.  It combines meditation with slow, gentle, graceful movements, as well as deep breathing and relaxation.  It has been found to have therapeutic benefits in patients with rheumatoid arthritis, osteoarthritis, and more recently fibromyalgia.

Based on the fact that Tai Chi is beneficial in patients with arthritis and other musculoskeletal disorders there have been several studies, which looked at the use of Tai Chi in patients with fibromyalgia. Basically all the studies show that the Tai Chi participants had significantly improvement in their measurements of pain, quality of life, improved sleep, and decreased fatigue and depression compared to the control group. Thus the Fibromyalgia pain cycle is broken.  Functional mobility and balance also improved which means less falls and injuries.  Tai Chi is also well tolerated meaning it did not produce major exercise related symptoms flares.

The major problem is finding a Tai Chi class.   Typically Tai Chi classes are most readily found at senior centers, and are only rarely found at your local gym.  If you can’t find Tai Chi classes near you then a great alternative is Tai Cheng.

tai ch

Tai Cheng is a 12 week home Tai Chi based exercise program developed by Dr. Mark Cheng.  Dr. Cheng drew on his 3-decade experience in Tai Chi, his PhD in Chinese medicine and acupuncture, and expertise with physical therapy-based corrective exercises to develop Tai Cheng.

Tai Cheng uses fluid, graceful movements, which improve your balance and coordination while increasing range of motion and flexibility.  The goals of regular practice of Tai Cheng as a home exercise program is to increase movement, decrease stiffness and improve strength.  When this happens, pain is decreased and one can begin to move out of the chronic pain cycle seen with Fibromyalgia and so many other chronic pain conditions.






Fibromyalgia is chronic musculoskeletal pain condition that, unfortunately, it is much too common (reported in nearly 5 million people in the US). It is characterized by widespread muscle and joint pain.

Patients with fibromyalgia complain of aches and pain all over their bodies. They often complain of fatigue — even on arising from sleep. Even if the sleep all night, people with fibromyalgia do not get good restorative sleep, causing them not to feel rested in the morning. Depression, cognitive dysfunction or “fibro fog”, migraine headaches, irritable bowel syndrome and other pain symptoms are commonly seen in patients with fibromyalgia.

The cause of fibromyalgia is unknown. The prevailing theory is that is due to an abnormal pain processing in the central nervous system resulting in hyperexcitability. This hyperexcitability results in a hypersensitivity to stimuli to both things that are usually painful but also things that should not cause pain.

There is no cure for fibromyalgia.  Nor is there any specific treatment that that will address all of the fibromyalgia symptoms. Instead, the mainstay of treatment has always been control of symptoms and pain with medicines.

Based on more than 100 published studies regular exercise is more commonly being recommended in the management of fibromyalgia. The studies have shown a benefit with exercise training in patients with fibromyalgia. Basically, those who participated in an exercise program were more likely to have reduced levels of pain, fatigue, depression, and have an improved quality of life and physical fitness.

For the best treatment efficacy the treatment of fibromyalgia should include a combination of both traditional and alternative treatments. Specifically a combination of medication, exercise and behavioral techniques should be used.


Works Cited:

Blotman, E. N. (2010). Aeorbic exercise in fibromyalgia: a practical review. Rheumatology International (30), 1143-1150.
Busche, A. J. (2011). Exercise Therapy for Fibromyalgia. Current Pain Headache Report (15), 358-367.
Randy Neblett, M. L. (2012, June). Fibromyalgia: An Overview of Etiology and Treatment Options. Practical Pain Management , 21-26.