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!

  4. I do not feel better with increased exercise. I used to run 10 miles a day in my early 20s. I’d do aerobics at local gyms and when I was in the USAF, based in Greece, my roommate and I would have our own aerobic workouts in our home for 1 hour everyday. During my late teens and 20s I loved the feeling of I’d get from working out, increased endorphins, increased muscle tone and the pain from working out while increasing strength, and stretched muscles. Ten years later the pain I once appreciated and understood to be increasing strength and muscle tone changed to constant, flu-like pain that caused me to feel exhausted and sick. The healthy exercise I once enjoyed and sought out on a daily basis caused continuous and increased muscle spasms each time I tried different types of exercising, i.e. elliptical machines, treadmills, low weights, pilates, yoga, light jogging, to name a few. I became very frustrated and have resorted to simply walking an hour a day. I’d sincerely like to be able to exercise the way I used to and have a toned body and be able to live an active and functional life but I have yet to be able to bear the pain other exercising creates.

    I also hate these articles that tell the world that “exercising helps fibromyalgia”. It doesn’t. When those without fibro pain read this they become experts on the disease and think it is their duty to tell me and other fibro sufferers that we are weak and are making our condition worse by not doing what they read, making them the experts. My own family thinks they know best and have no respect or understanding of me and the pain I have to deal with on a daily basis, only because they’ve read an article or spoke with a person who claims to have fibromyalgia and works out at the gym. It has caused intense friction in how my family treats me if I am late to a function or if I choose to not attend due to the pain, fatigue and depression this horrible condition or disease (?) Inflicts on my body and my daily life.

    • Laurie Zubritsky says:

      I hear your pain (no pun intended). My daughters fatigue and nerve pain only got worse with exercise. I hate these studies, our former doctor latched on to that as a miracle cure, but not true for so many. Only thing that helped was Low Dose Naltrexone LDN. My daughter has continued to improve over many months of taking it, it will be a year in March. I hope that might help you too. Good luck

  5. sandra dunbar says:

    ” You-all ” are me! Most days I feel like I will never be able to move again– nor do I want to. I would be ok if I didn’t wake “cause other than unbearable pain I’ve had a fantastic life. After some good pain meds (something with opiate ) I’m ready to go RVing again! I expect the pain-relief-police will come after us next…. Can we go (all of us ) live somewhere that will let us treat our pain and be believed? Most days I wonder if it’s worth it…….

  6. Lindsey says:

    Hi Kelli- I hate that your family doesn’t try to understand what you’re going through. Sounds like they just cause you more undue stress which will make you feel worse. You are right, talking to people and reading an article doesn’t make you an expert. Fibro is so complex. They may think they are helping but in reality they don’t know a thing. What helps one person does not necessarily help another. No two people with fibro alike. I used to walk with my mom and I do remember it helping. But it wasn’t just the exercise that helped it was having something to look forward to during the day and being able to hang out with my mom during lunch. Now when I try to exercise I’m in so much pain. It’s hard to find something that you enjoy and isn’t too rough on the body. Again, everyone is different.
    It just pains me to hear how unsupportive they are of you. Having people or just a person around you who understands or at least tries to understand what you go through on a daily basis helps. Hope you find some good support soon.

  7. I have found that doing exercises in the ocean 5 days per week has been helpful, but I do need to sleep for an hour afterwards. Sometimes I do over do it and am in a great deal of pain, so the next day I walk for 30 minutes. being in the sunshine has helped with the mood. I have found that no medication helps with the pain. I work in a call centre 15 hours per fortnight where I don’t feel any pain, as I am immersed in my work, however the next day I am exhausted.

  8. I have found that doing exercises in the ocean 5 days a week has helped with the pain. I do need to sleep for an hour afterwards. Some days I over do it, so the next day I walk for half an hour. I have recently found that massage helps a bit after the exercise. I work 15 hours a fortnight and feel little pain at work as I’m focusing on the work, but the next day I’m too exhausted to do anything. I find no benefit in any pain medications. I do try to get sunshine most days as it helps with mood. I do find changes in weather affects my pain in particular before it rains.

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