What is Fibromyalgia?
Fibromyalgia is a long-term condition that causes widespread pain throughout the body. People with fibromyalgia often feel increased sensitivity to pain. Even gentle touch or pressure can sometimes feel uncomfortable. This is sometimes called allodynia.
Other common symptoms may include tiredness, difficulty sleeping, stiffness, and problems with thinking and memory. Some people also experience anxiety or low mood. The condition is thought to affect between 2% and 4% of people worldwide. It appears to be more common in women than in men.
Researchers are still working to understand what causes fibromyalgia. Its underlying mechanisms are not yet fully clear. Because of this, treatment often involves a combination of approaches.
How is Fibromyalgia Currently Managed?
Because fibromyalgia affects people in different ways, management typically involves a range of strategies tailored to the individual. These may include lifestyle changes such as dietary adjustments and stress management, physiotherapy, medications prescribed by a clinician based on individual needs, and structured exercise programmes.
The right approach depends on each person’s circumstances. A healthcare professional can help you explore which options may be most suitable.
What Does the Latest Research Say About Aerobic Exercise and Fibromyalgia Pain?
A recent systematic review and meta-analysis published in the European Journal of Pain in 2025 aimed to find out how different amounts of aerobic exercise might affect pain in people with fibromyalgia.
The researchers looked at 17 randomised controlled trials. These are studies where participants are randomly placed into different groups to compare treatments more fairly. In total, 1,095 people took part. Nearly all participants were women.
The review used the FITT-VP model. This stands for Frequency, Intensity, Type, Time, Volume, and Progression. It is a way of breaking down the “dose” of exercise to understand which aspects matter most.
What Types of Exercise Were Studied?
The studies included several forms of aerobic exercise, such as walking (outdoors and on a treadmill), swimming, pool-based exercise, stationary cycling, and music-based exercise classes.
Of these, pool-based exercise, swimming, and walking appeared to produce the most meaningful improvements in pain scores. Interval training did not appear to reach a clinically meaningful difference. However, this may be partly because it was only examined in two studies.
The researchers noted that the most important factor when choosing an exercise type should be what the patient is most likely to enjoy and stick with. Patient preference and practical access are key to long-term adherence.
How Often and for How Long Should You Exercise?
The review examined several aspects of exercise “dosing.” Here is a summary of the findings:
Frequency: Exercising two to three times per week appeared to produce clinically meaningful pain improvements.
Intensity: Only vigorous-intensity exercise reached a clinically meaningful difference. However, patients may benefit from starting at a low intensity and building up gradually.
Type: Pool-based exercise, swimming, and walking (treadmill or outdoors) appeared most beneficial. Choosing an enjoyable activity may support long-term adherence.
Duration per session: Sessions lasting 25–40 minutes appeared to be linked with the greatest improvements.
Programme length: Programmes lasting at least 6 weeks appeared necessary to achieve meaningful changes.
Weekly volume: Exercising for more than 100 minutes per week appeared to reach the threshold for clinically meaningful change.
Progression: Gradually increasing exercise intensity over time appeared to produce better outcomes than increasing volume alone.
What Are the Limitations of This Research?
While these findings are encouraging, it is important to understand the limitations of this review.
Mixed quality of evidence: Of the 17 studies, only six had a low risk of bias. Five raised some concerns, and six had a high risk of bias. The overall quality of evidence was rated as low using the GRADE system.
Small and mostly female samples: The studies included 1,095 participants in total, but only seven were male. This makes it difficult to know whether the findings apply equally to men.
Limited data on some factors: Only five studies reported on exercise progression. Some subgroups were based on just one or two studies.
Variation between studies: The studies used different types of exercise, pain measures, and programme lengths. This makes direct comparisons more difficult.
Not individual proof: This review analyses existing trial data. It does not prove that a specific exercise programme will work for every person with fibromyalgia.
The researchers themselves noted that more studies are needed. These results should be considered as part of a broader picture, rather than definitive guidance.
What Could This Mean for People Living with Fibromyalgia?
Based on this review, aerobic exercise may play a helpful role in managing fibromyalgia pain for some people. The evidence suggests that a programme involving two to three sessions per week, lasting 25–40 minutes each, could be a reasonable starting point.
The researchers recommend starting at a low intensity and gradually building up over six to twelve weeks. The type of exercise should be chosen based on what the individual enjoys and can realistically maintain. Walking and swimming were among the activities that appeared most promising.
People with fibromyalgia often have lower physical fitness levels than the general population. Any new exercise programme should be discussed with a healthcare professional who can help design a safe and appropriate plan.
Important: This article summarises findings from a single systematic review. It is for general information only and does not constitute medical advice. Exercise is just one of many approaches that may be considered for fibromyalgia. Always speak to a qualified healthcare professional before starting a new exercise programme or changing your current treatment.
Thinking About Your Treatment Options?
If you are living with fibromyalgia and would like to explore whether you may be eligible for a consultation, our clinical team is here to help. We offer personalised assessments to discuss your symptoms and previous treatments to understand if medical cannabis may be appropriate for you. To understand if you may be eligible for an appointment, complete an eligibility assessment today.
