From Our 2010 Archives
Tai Chi: Best Fibromyalgia Treatment?
Latest Chronic Pain News
Study Shows Fibromyalgia Symptoms Much Better After 12 Weeks of Tai Chi
Daniel J. DeNoon
Reviewed By Laura J. Martin, MD
Compared with patients who received wellness education and stretching exercises, those who practiced tai chi saw their fibromyalgia become much less severe. They also slept better, felt better, had less pain, had more energy, and had better physical and mental health, says study researcher Chenchen Wang, MD, of Tufts University School of Medicine.
"We definitely saw better results than reported in trials of drug treatments for fibromyalgia," Wang tells WebMD. "One patient with previous arthritis pain kept saying, 'No pain! No pain!'"
It wasn't for everyone. Wang says 10% to 20% of patients randomly assigned to tai chi did not feel it helped them. But he says 50% to 60% of the patients were "really engaged," and after about eight weeks began to feel better.
Improvement was gradual but steady. Patients who benefited from tai chi asked the researchers to continue the program when the 24-week study ended.
The Wang study was relatively small, with 66 patients evenly divided between the tai chi and education/stretching groups. Wang says the results should be confirmed in a larger trial.
Gloria Y. Yeh, MD, MPH, of Harvard Medical School, agrees.
But Yeh says patients should not wait to for the results of such studies.
"Tai chi may be an ideal exercise option for patients with fibromyalgia. It seems to be safe and effective," Yeh tells WebMD via email. "If you are a patient suffering with fibromyalgia without much relief from conventional options -- or are looking for more you can do for yourself -- there is no reason not to give tai chi a try."
Tai Chi for Fibromyalgia -- and Arthritis
Tai chi essentially is a mind/body exercise rooted in thousands of years of Chinese culture and philosophy. A basic tenet is that a healthy body requires a strong mind. Practice involves using meditation, breath control, and strong but gentle motions to direct the flow of physical and spiritual energy through the body.
Over the past decade, Wang's team has found that tai chi helps patients with a variety of long-term health conditions. That led them to their fibromyalgia clinical trial, which enrolled 66 patients who had suffered from fibromyalgia for 11 years on average.
The patients were told they were in a study of two different exercise regimens, in which one group would receive nutrition education. Wang says most patients had hoped to be included in the education/exercise group, which they were led to believe was the more sophisticated intervention. In reality, that was the comparison group, in which 33 patients received twice-weekly, hour-long wellness education and did stretching exercises.
The other group worked with tai chi master Ramel Rones of Boston's Mind-Body Therapies. Hour-long training sessions took place twice a week for 12 weeks. They included an explanation of tai chi theory and instruction in 10 "forms" of the classic Yang style of tai chi. Training also included training in meditation, breathing techniques, and relaxation. Patients were told to practice at home for at least 20 minutes a day.
"The Yang style is very soft and gentle. We always teach the gentle, slow, big movements and lots of meditation," Wang says.
Fibromyalgia patients aren't the only ones to benefit. At the University of North Carolina, Chapel Hill, Leigh F. Callahan, PhD, and colleagues have just completed a study of tai chi for patients with rheumatoid arthritis.
"We found very similar results to the Wang study," Callahan tells WebMD. "We found improvement in pain, stiffness, and fatigue. We saw improvements in sleep measure, self-efficacy, and balance. And people with arthritis were more aware of the space around them and had more confidence that they are not going to fall as easily."
Patients in the Wang and Callahan studies did not stop taking prescribed medications, although patients in the Wang study reported taking their medications less often. Callahan says tai chi is not meant to replace other treatments but should be added to other effective therapies.
What is it about tai chi that is so helpful? Wang and Callahan each say it's not a single thing. Tai chi is a complex integration of mental, spiritual, philosophical, and physical practices. Moreover, patients tend to bond with one another in the classes. Wang and Callahan both report that patients bond with one another in ways that clearly add to the positive effects.
While Wang's patients studied with a master trainer who has more than 20 years of experience teaching tai chi, Callahan reports that newly trained, certified instructors seem to be just as effective as master trainers in helping patients with chronic disease.
"Tell patients there are no side effects," Wang says. "Some patients still find they have pain -- exercise always leads to some pain -- but this is very safe."
The Wang study, and an editorial by Yeh and colleagues, appear in the Aug. 19 issue of the New England Journal of Medicine.
SOURCES: Wang, C. New England Journal of Medicine, Aug. 19, 2010; vol 363: pp 743-754.
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