Reduce the Symptoms of Fibromyalgia with Tai Chi
By John M. de Castro, Ph.D.
“Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment. This mind-body approach may be considered a therapeutic option in the multi-disciplinary management of fibromyalgia.” – Wang et al.
Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.
There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But, these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Mindfulness practices that are also exercises may be particularly effective. Indeed, yoga practice has been shown to improve the symptoms of fibromyalgia. This suggests that Tai Chi, another mindful exercise might be similarly effective.
In today’s Research News article “Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861462/ ), Wang and colleagues recruited patients with fibromyalgia and randomly assigned them to one of three groups; 60 minutes of Tai Chi once a week for 24 weeks, 60 minutes of Tai Chi twice a week for 12 weeks, or 60 minutes of light to moderate aerobic exercises twice a week for 24 weeks. Participants were encouraged to practice at home and continue the exercises after the end of formal sessions. Participants were measured before and at 12, 24, and 52 weeks into the intervention for overall severity of fibromyalgia, including intensity of pain, physical function, fatigue, morning tiredness, depression, anxiety, job difficulty, and overall wellbeing, anxiety, depression, self-efficacy, sleep quality, symptom severity, physical and mental health, coping strategies, social support, disability, and physical function, including muscle strength and power.
They found that at 24 and again at 52 weeks all groups showed significant improvement but the Tai Chi groups had significantly greater improvement than the aerobic exercise group in overall fibromyalgia severity, self-efficacy, anxiety, and coping strategies. Hence, participation in Tai Chi exercise produce significant improvement in the symptoms of fibromyalgia that were better than those produced by aerobic exercise.
These are remarkable findings that Tai Chi practice is better than aerobic exercise in treating the symptoms of fibromyalgia. Both helped, but Tai Chi helped more. Fibromyalgia patients suffer greatly and to bring relief with a simple, gentle, safe exercise is very important. Tai Chi is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence, Tai Chi practice would appear to be a wonderful effective treatment for the relief of the suffering of fibromyalgia patients.
So, reduce the symptoms of fibromyalgia with Tai Chi.
“The authors attributed the success of the program to the postures and low impact movements of Tai Chi, and to the “controlled breathing and movements leading to restful state and mental tranquility.” Pain thresholds were likely raised in the process, which helped break the cycle of movement pain.“ – Joanna Fernandes
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Wang, C., Schmid, C. H., Fielding, R. A., Harvey, W. F., Reid, K. F., Price, L. L., … McAlindon, T. (2018). Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. The BMJ, 360, k851. http://doi.org/10.1136/bmj.k851
Abstract
Objectives
To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration.
Design
Prospective, randomized, 52 week, single blind comparative effectiveness trial.
Setting
Urban tertiary care academic hospital in the United States between March 2012 and September 2016.
Participants
226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group.
Interventions
Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone.
Main outcome measures
The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life.
Results
FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group difference in FIQR scores=16.2 points, 8.7 to 23.6, P<0.001). The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks (difference in FIQR scores=9.6 points, 2.6 to 16.6, P=0.007). There was no significant increase in benefit for groups who received tai chi twice weekly compared with once weekly. Participants attended the tai chi training sessions more often than participants attended aerobic exercise. The effects of tai chi were consistent across all instructors. No serious adverse events related to the interventions were reported.
Conclusion
Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment, for a variety of outcomes for patients with fibromyalgia. Longer duration of tai chi showed greater improvement. This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861462/