Aerobic Exercise¹
Cardiovascular exercise is stated to be helpful in rehabilitation from Fibromyalgia.

The guidelines most commonly given involve the patient performing active aerobic exercise three times weekly (some say four times) for at least 20 (some say 15) minutes during which time they are required to achieve between 60 and 85% of their maximum predicted heart rate. The methods of exercise best suited to Fibromyalgia patients are said to be cycling (static cycle) walking or swimming.

Appropriate warmup and warmdown periods are suggested and a slow incremental programme is needed to reach the prescribed length and frequency of exercising. The release of hormone-like substances (endogenous endorphins) during aerobic exercise is thought to offer the means whereby pain relief and well-being are enhanced, along with the obvious increased self-esteem and psychological boost which comes with increased fitness.

A study involving 34 patients with fibromyalgia had some of the patients perform aerobic exercise (cycle exercise which was designed to achieve a heart rate of 150 per minute) or flexibility exercises (achieving no more than 115 beats per minute) three times a week for 20 weeks. At the end of this period those patients doing the aerobic routines achieved far greater reduction in pain than the flexibility group.

People with CFS(ME) may be unable to do any exercise at all in some stages of their illness.

See the discussion below on cognitive/behavioural treatment in which tasks and routines (which have been agreed and negotiated between the CFS patient and the therapist) are performed daily with slight increments over time, whatever the patient feels (and whether they are having a good day or a bad day) always staying without strain.

Acupuncture^2,3,4
Acupuncture in general and electroacupuncture in particular has an excellent track record in treatment of pain.

One of the leading experts in use of acupuncture in pain relief is Dr.P.Baldry after asserting categorically that acupuncture is certainly the treatment of choice for dealing with Myofascial Pain Syndrome or trigger point problems states:

"The pain in Fibromyalgia, which would seem to be due to some as yet unidentified noxious substance in the circulation giving rise to neural hyperactivity at tender points and trigger points takes a protracted course and it is only possible by means of acupuncture to suppress this neural hyperactivity for short periods".

As is clear there are other ways, however if acupuncture is used for Fibromyalgia Baldry believes that it is necessary to repeat treatment every 2 to 3 weeks for months or even years, which he regards as unsatisfactory, "but nevertheless some patients insist that it improves the quality of their lives".

Relief from pain for weeks on end and an enhanced quality of life would seem quite a desirable objective, perhaps helping ease the pain burden while more fundamental approaches are dealing with constitutional and causative issues.