Exercise has always been a part of Suzanne Wickremasinghe’s life. You might even say it was her life until debilitating pain struck her body.

“Stress was a huge factor in my illness escalating as it did,” explains Wickremasinghe.

“One cause of my stress was knowing how good exercise should be for my body and pushing myself to work out, then going beyond my limits often, even when my body was telling me to stop.”

This drive is what eventually led to Wickremasinghe’s body giving out on her to the point where she couldn’t do anything — not even walk up the stairs at her home without feeling exhausted.

“When I learned that I’d developed chronic fatigue syndrome and fibromyalgia, I knew that I needed to find a way to exercise again, because proper exercise is vital for the body’s healing process,” she tells Healthline.

“I felt that not only would the right kind of exercise reduce my pain and fatigue, but it would improve my mood and reduce my stress,” she says.

That’s why Wickremasinghe’s made it her mission to find ways to take the pain out of exercise for people with fibromyalgia.

In as little as 5 minutes a day, you can lessen your pain, too.

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“When I was first diagnosed [with fibromyalgia], I limited my exercise to just stretching and light walking, because every workout routine I tried made me feel worse,” Wickremasinghe says about deciding to develop workouts modified for being prone to pain and lower energy. Photo via Suzanne Wickremasinghe.

What is fibromyalgia?

Fibromyalgia is a long-lasting or chronic disorder that causes extreme muscle pain and fatigue.

Fibromyalgia affects about four million adults in the United States. That’s about 2 percent of the adult population. It’s twice as common in women as men.

The causes of the condition are unknown, but current research is looking at how different parts of the nervous system may contribute to fibromyalgia pain.

Why do certain exercises make fibromyalgia symptoms worse?

Many people are under the false assumption that exercise isn’t suitable for those dealing with fibromyalgia and will lead to more pain.

But the problem isn’t exercising. It’s the type of physical activity people are doing.

“Exercise-related pain is very common with fibromyalgia,” explains Mously LeBlanc, MD. “It’s not about exercising hard (which causes significant pain); it’s about exercising appropriately to help improve symptoms.”

She also tells Healthline that the key to optimal pain relief for people with fibromyalgia is being consistent with physical activity.

Dr. Jacob Teitelbaum, an expert on fibromyalgia, says that exercising hard (overexertion) leads to the problems people experience post-exercise, which are called “post-exertional malaise.”

He says this occurs because people with fibromyalgia don’t have the energy to condition like others who can handle the increase in exercise and conditioning.

Instead, if the exercise uses more than the limited amount of energy the body can make, their systems crash, and they feel like they were hit by a truck for a few days after.

Because of this, Teitelbaum says the key is to find an amount of walking or other low-intensity exercises you can do, where you feel “good tired” after and better the next day.

Then, instead of ramping up in the length or intensity of your workouts, stick to the same amount while working to increase energy production.

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“Even now, if I let four or five days go by without working out, I notice that some of my pain comes back. So, consistent exercise is vital for me to have a decent quality of life,” Wickremasinghe says. Photo via Suzanne Wickremasinghe.

How you can manage post-workout flare-ups

When it comes to exercise and fibromyalgia, the goal is to start gradually and move toward moderate intensity.

“Exercise that’s too intense for the individual, or [done] for too long, exacerbates pain,” says LeBlanc. That’s why she says starting slow and low is the best approach for success. “As little as 5 minutes a day can impact pain in a positive way.”

LeBlanc instructs her patients to do water exercises, walk on an elliptical machine, or do gentle yoga. For the best results, she also encourages them to exercise daily for short periods (15 minutes at a time).

If you’re too sick to walk, Teitelbaum says to start with conditioning (and even walking) in a warm-water pool. This can help you get to the point where you can walk outside.

Also, Teitelbaum says that people with fibromyalgia have a problem called orthostatic intolerance. “This means when they stand up, the blood rushes to their legs and stays there,” he explains.

He says this can be helped dramatically by increasing water and salt intake as well as by using medium pressure (20 to 30 mmHg) compression stockings when they’re up and around. In these situations, using a recumbent bicycle can also be very helpful for exercising.

In addition to walking and water workouts, several studies also cite yoga and tai chi as two methods of exercise that help increase physical activity without causing flare-ups.

The best exercise routine for people with fibromyalgia

  • Exercise consistently (aim for daily) for 15 minutes.
  • As little as 5 minutes a day can reduce your pain.
  • Aim to feel “good tired” after a workout but better the next day.
  • If exercising increases your pain, go easier and exercise for less time.
  • Don’t try to ramp up in time or intensity unless you notice an increase in energy.

7 tips to help you get started and feel better

Information on how to get into shape is abundant and easily accessible. Unfortunately, many of the recommendations are for relatively healthy people who don’t experience chronic pain.

Typically, what ends up happening, says Wickremasinghe, is people with fibromyalgia push themselves too hard or try to do what healthier people are doing. Then they hit a wall, feel more pain, and give up.

Finding fitness tips that specifically address fibromyalgia is critical to your success.

That’s why Wickremasinghe decided to create a method of working out for herself, and others, who are dealing with fibromyalgia.

Through her site Cocolime Fitness, she shares workouts, tips, and inspirational stories for people who are dealing with fibromyalgia, fatigue, and more.

Here are some of Wickremasinghe’s best tips:

  • Always listen to your body and only exercise when you have the energy to do so, never doing more than your body wants you to do.
  • Take several breaks in-between exercises to recover. You can also split the workouts into 5- to 10-minute sections that can be done throughout the day.
  • Stretch daily to help with posture and increase mobility. This will lead to less pain when you’re active.
  • Stick with low-impact movements to prevent excess soreness.
  • Avoid going into high-intensity mode while recovering (no more than 60 percent of your maximum heart rate). Staying below this zone will help prevent fatigue.
  • Keep all your movements fluid and limit the range of motion in a particular exercise whenever it causes pain.
  • Keep records of how a particular exercise routine or activity makes you feel for up to two to three days afterward to see if the routine is sustainable and healthy for your current pain level.

Most importantly, Wickremasinghe says to find exercises that you love, that don’t stress you out, and that you look forward to doing most days. Because when it comes to healing and feeling better, consistency is key.


Sara Lindberg, BS, M.Ed, is a freelance health and fitness writer. She holds a bachelor’s in exercise science and a master’s degree in counseling. She’s spent her life educating people on the importance of health, wellness, mindset, and mental health. She specializes in the mind-body connection, with a focus on how our mental and emotional well-being impacts our physical fitness and health.