A recent clinical study found participants who undertook Tai Chi improved at all times on several outcomes circulating around pain and discomfort associated with Fibromyalgia, a complex disorder characterized by chronic widespread pain, fatigue, sleep disturbance, and prominent physical and psychological impairment, whereas participants who undertook aerobic exercise showed less improvement. Fibromyalgia affects approximately 2-4% of the general population between 18 and 65 years of age worldwide. The disorder is not well understood, however, it is classified as an issue with your body’s ability to regulate pain. This is associated with neuroendocrinologic changes in the central and peripheral nervous systems. Although there is no cure for fibromyalgia, a traditional western treatment plan may combine multidisciplinary approaches including drugs, exercise, cognitive behavioral therapy, and health education.
Pharmaceutical drugs, such as analgesics seem to only offer short term benefits for various symptoms, but recent reviews question whether they have a sustained, clinically meaningful responses. On top of that, many patients flat out just stop using their prescribed therapies usually because they don’t work, makes them feel worse or leads to other complications, including drug intolerance cases. More disturbingly, an addition, 11% to 69% of patients in recent large retrospective database studies reported use of short acting or long acting opioids, which carries the risk of dependency and misuse, despite evidence showing that patients with fibromyalgia receiving opioids have poorer health outcomes than those receiving non-opioids. So that makes me ask, why use low yield opiods that have a high risk for the user to develop a dependency. In medicine, this is a great example of a situation that should be avoided at all costs. To me, its equivalent of forcing individuals to consume something they have a known allergy to, what’s the benefit? Do they outweigh the costs? Evidently, pharmacotherapy is insufficient to resolve persistent symptoms and improve quality of life for patients with fibromyalgia.
Lucky for us, Dr. Wang and colleagues took an interest in how exercise has specifically changed the way we think about approaching disease. The benefits of exercise training have been documented in the literature, and moderate aerobic exercise is currently recommended as part of standard care for the management of fibromyalgia. However, many patients have difficulties performing and adhering to exercise programs owing to fluctuations in symptoms, and they remain unfit, however, Tai chi is an ancient discipline involving exercise rooted in traditional Chinese medicine that originated as a martial art and has been practiced for many centuries. This complex, multicomponent mind-body intervention integrates physical, psychosocial, spiritual, and behavioral elements to promote health and fitness. Two previous 12 week randomized trials found that tai chi effectively alleviates pain and improves physical and mental health in patients with fibromyalgia compared with wellness education or stretching controls. Similar beneficial effects of tai chi have been shown in patients with osteoarthritis and rheumatoid arthritis. Despite evidence suggesting that tai chi has therapeutic benefits for musculoskeletal conditions, the relative benefits and harms of tai chi compared with aerobic exercise, a common treatment for this population, need to be explored. Furthermore, the ideal dose (frequency or duration) of tai chi as a treatment for fibromyalgia has not been determined.
However, since this study did find that tai chi mind-body intervention results in similar or greater symptom improvement compared with aerobic exercise associated with a more traditional treatment route and the current most commonly prescribed non-drug treatment for patients with fibromyalgia, it is only a matter of time before studies clarifying some of the biggest questions in regards to associated harms or how to prescribe this will be answered. These results are also consistent with those of other small, shorter efficacy trials that showed the benefits of mind-body practices such as Tai Chi, qigong, and yoga for pain and physical and psychological health, compared with various interventions for fibromyalgia and other chronic pain conditions.
By improving psychological wellbeing, coping, and self efficacy, tai chi mind-body exercise may help to bolster the confidence of patients with fibromyalgia to engage in behaviors that help them manage their symptoms and to persist in those behaviors. In light of these complex multicomponent mind-body interactions on and with various active behavioral elements, tai chi may be especially well suited to the treatment of fibromyalgia.