Exercising in a warm pool offers multiple benefits for people with fibromyalgia who avoid traditional land-based physical activity because it is too painful. Water workouts can improve overall fitness while putting less stress on the body.

See How to Get a Fibromyalgia Diagnosis

Water exercise can help reduce the muscle tightness of fibromyalgia without high impact.

How Water Alleviates Fibromyalgia Symptoms

The water’s buoyancy eases stress on the joints, and its warmth helps tight muscles relax. This reduces stiffness and alleviates muscle spasms, resulting in greater flexibility and range of motion than is possible with land-based activities.

See Water Therapy for Osteoarthritis

The individual’s body is supported by the water, reducing the chance of injury from losing one’s balance. At the same time, the pressure of the water boosts heart and lung strength and enhances blood flow.

The soothing effect of the water may also reduce the perception of pain, helping lower anxiety— two common problems experienced with fibromyalgia. 1 Segura-jiménez V, Carbonell-baeza A, Aparicio VA, et al. A warm water pool-based exercise program decreases immediate pain in female fibromyalgia patients: uncontrolled clinical trial. Int J Sports Med. 2013;34(7):600-5.

See Characteristic Symptoms of Fibromyalgia


Two Good Options: Water Exercises and Hydrotherapy

Public pools and pools in recreation centers and fitness clubs often offer varying kinds of water workouts that could be helpful for people with fibromyalgia.

Water exercise typically refers to exercises done individually or in a group to promote fitness and general health. A water exercise class designed for people with fibromyalgia would typically address common physical challenges.

See Ways to Get Exercise When You Have Arthritis

Hydrotherapy, also called aquatic physical therapy or pool therapy, is usually more focused on the individual, and conducted in small groups or in one-on-one sessions. Goals are generally more specific and include improving function, balance, coordination, and flexibility.

See Hydrotherapy for Arthritis

Both water exercise classes and hydrotherapy pools use warmer water than standard swimming pools—a welcome feature for cold-sensitive fibromyalgia patients. Hydrotherapy pools are the warmest, with water often more than 90 degrees, while the water temperature in exercise classes ranges between 83 to 88º F. Air temperatures are also typically elevated for exercise classes and hydrotherapy.

See 9 Easy Ways to Apply Heat to an Arthritic Joint

What to Expect in the Water

People usually stand in the water—rather than swim—to perform the exercises. It is not necessary to know how to swim to participate. Water walking, leg lifts, and stretches are common moves. Flotation devices and ankle weights are often used to adjust the amount of buoyancy.

See Knee Strengthening Exercises

There are many different types of water exercise. The instructor or physical therapist may emphasize one approach or use a mix of styles to suit participants’ needs. These are some options:

  • Ai Chi, adapted from land-based tai chi, emphasizes deep breathing, slow movements, and relaxation.
  • Watsu blends stretches and special breathing while floating or being held by a practitioner of the relaxation technique.
  • Backhab was originally designed for people with back problems, but the focus on relearning basic functions to improve daily life also works well for those with fibromyalgia.

See Tai Chi and Yoga for Arthritis

While these exercises can be done independently, it may be helpful to start with a supervised program to learn the best exercises and proper form.


Swimming Boosts Flexibility

Swimming has many of the same benefits as a program of specific water exercises. The movements help the back and neck stay more flexible, and the exertion enhances circulation as well as heart and lung function.

See Aerobic Exercise for Shoulder Arthritis

Pools used mainly for swimming are typically not as warm as pools used for water exercises or hydrotherapy. Those who find swimming in warmer pools more helpful are advised to ask about the water temperature in advance.

Swimming can be a relaxing form of exercise, but like other forms of physical activity, it is important to increase the amount of exercise gradually. People with fibromyalgia often do not to feel the effects of overexertion until the next day, making it important to introduce swimming gradually, especially in the first few sessions. It is also important that the fibromyalgia sufferer be alerted that post-exercise soreness is very “normal” and to “expect it,” so they do not misinterpret this, resulting in an inappropriate discontinuation of this important exercise approach.

Watch Video: Should I Exercise Through Joint Pain?

Water exercise can be a crucial first step toward improved muscle strength and overall fitness. Exercises can be done in the water first, where they are easier, and gradually shifted to land as the person’s fitness improves.

  • 1 Segura-jiménez V, Carbonell-baeza A, Aparicio VA, et al. A warm water pool-based exercise program decreases immediate pain in female fibromyalgia patients: uncontrolled clinical trial. Int J Sports Med. 2013;34(7):600-5.

Dr. Naomi Feuer is a neurologist at NewYork-Presbyterian Hospital. She has more than 10 years of clinical experience and specializes in diagnostic testing, nerve testing, pain management, and physical therapy. Dr. Feuer serves as Assistant Clinical Professor of Neurology and Neuromuscular Disease at Weill Cornell Medical Center.