Fibromyalgia Pain Linked to Muscle Metabolites, Reduced by Exercise

Fibromyalgia Pain Linked to Muscle Metabolites, Reduced by Exercise

Exercise may lower the levels of muscle metabolites that can trigger pain in fibromyalgia patients, according to a new study.

The study, Increased Interstitial Concentrations of Glutamate and Pyruvate in Vastus Lateralis of Women with Fibromyalgia Syndrome Are Normalized after an Exercise Intervention – A Case-Control Study, was published in the journal PLOS ONE.

But because the normalization of metabolites was not enough to successfully reduce all pain among participants of the study, researchers suggest that fibromyalgia pain results from changes in muscles and communications in the brain.

Increasing evidence from previous studies had linked brain and spinal cord neuron signaling to pain in fibromyalgia. Additionally, it has been suggested that muscles hold many factors that could potentially increase pain sensitivity, but few studies had investigated how they muscles relate to the disease.

Because exercise is reported to reduce pain in fibromyalgia, researchers at Linköping University in Sweden sought to explore molecular changes that might bring about such improvement.

The team recruited 29 women with fibromyalgia and 28 healthy volunteers. Concentrating on the participants’ largest thigh muscle, the researchers measured a range of muscle factors using a method called microdialysis, which can measure metabolite levels surrounding muscle cells.

Researchers also examined overall body measurements, blood pressure, level of psychological distress, and aspects of quality of life. Additionally, they established the number of tender points, duration of pain, pressure pain threshold, and physical capacity.

Tests at the start of the study showed that women with fibromyalgia had higher levels of glutamate (known to be involved in pain signaling), pyruvate, and lactate.

After a 15-week exercise intervention focusing on resistance training of the legs, fibromyalgia patients had significantly lower levels of the metabolites glutamate, pyruvate, and glucose in their thigh muscles than at study start. Pain intensity levels among patients had also dropped. There were no such changes in the control group.

The team found that the decreased pain intensity after the exercise intervention correlated with lower levels of pyruvate and glucose, indicating that changes in muscle metabolites likely produced the positive effects of exercise on pain.

“This study supports the suggestion that peripheral metabolic and algesic muscle alterations are present in FMS [fibromyalgia syndrome] patients and that these alterations contribute to pain. After an exercise intervention, alterations normalized, pain intensity decreased (but not abolished), and strength and endurance improved, all findings that suggest the effects of exercise are partially peripheral,” according to the report.

Because all patients still experienced pain after the intervention, the researchers believe that fibromyalgia pain may be the result of factors associated with both the brain and muscles.


  1. Mandy says:

    I believe in what this article is saying whole-heartedly! I was diagnosed with Fibro after a car accident 3 years ago and I tend to feel more pain if I stand, sit or lie down for long periods of time. The one thing that helps is walking, which I try to do almost every day, and I find this eases some of the pain in my back and pelvis. I also try to do some exercises with a resistance band once a week for my shoulders and arms (this only happens when I’m not doing anything else physical). I still feel pain and sometimes I overdo things, but I feel stronger and more in-control of my body rather than the other way around. I also feel that the regular exercise helps with regulating my moods and I’m less prone to depression than I used to be.

  2. Est says:

    Exercise recommended by my doctor made me feel worse, not better. If exercise is all they have for fibro and it makes me worse, I question whether it’s what I have despite hitting the diagnosis criteria. I am “severe.” Most people will say “well you did it wrong or didn’t give it long enough” – unfortunately untrue in my case. I tried walking for miles several times a week for a few years. Every time I felt worse, not better. It helped nothing: not my depression, my anxiety, not my pain. I’m the type of patient all the studies don’t want you to hear about. Medication and exercise don’t help me. Eating “better” (I ate well before) doesn’t help me. Yoga/tai chi doesn’t help me. Therapy doesn’t help me. I’m fueled purely by spite, find something that works instead of trying to convince people this works. If the pace trial was anything to go off of, there’s an ulterior motive to insist solely on therapy and exercise as the solution for “hysterical women” in pain to quote some of our “critics.”

    • Sandra says:

      I’m awfully sorry but don’t these people who make up these studies ever read? I was diagnosed in 1996…not many years after WHO first recognized Fibro as a thing. We knew then it was a neurotransmitter disorder, and duh, there were changes in the muscle. We knew all about substance P and all that. The only things that hadn’t been done yet were the biopsies that showed the muscle stuff was real, not somatic, that there were, evidenced by tissue samples, changes in the muscle tissue/cells not to mention the fascia and the MRI’s showing brain changes. Why do they continue to waste money on things already established?

  3. Grace from Australia says:

    All exercise done repeatedly has resulted in injury for me. I have to mix activities and even than I end up in additional pain compared to normal levels. You just can’t win!

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