Aerobic exercise was compared with stress management and treatment-as-usual for those with fibromyalgia.
Those who engaged in aerobic exercise showed the greatest improvement in pain levels, sleep patterns and feelings of depression as well as increased energy. The authors expressed surprise at this conclusion, since the subjects in the aerobic exercise group were the most sceptical about exercise as a form of treatment. At the four-year follow-up, the aerobic group was the one most likely to have carried on using exercise as a form of treatment.
T'ai-chi is a form of gentle exercise from China designed to relax the body, and to allow vital energy, or chi, to flow freely. Once it has been mastered in all its aspects, including deep, regular breathing, it can then be used to help alleviate symptoms, proponents say.
In all, there are 300 postures to learn, but the most important aspect of the technique is the spiritual development brought about by Chi Kung training, which involves standing in certain positions while using breathing and visualization to increase the flow of chi through the body.
Qigong is similar to T'ai-chi in as much as it is a gentle exercise regime from China that seeks to improve the flow of chi, or life energy, through the body.
Proponents claim it has cured many conditions, including arthritis, but there is virtually no good, valid scientific evidence to support these claims. Instead, it should be viewed as a gentle way to improve general well-being and health.
The postures and movements of Qigong can be easily learnt from books and videos, and can be performed walking, standing, sitting in a wheelchair, or even lying down. And, as with T'ai-chi, it also involves visualization, deep breathing and exact movements. It's worth adding that if you suffer from dizzy spells, or are prone to bleeding, then Qigong is best avoided.
Some hatha yoga advocates claim it offers a cure for arthritis if undertaken with a correct diet, and suggest this can be achieved within two months for early-stage arthritis, and five months for chronic cases.
They recommend a series of postures, or asanas, that will help arthritis, including (and here we give the English version of the posture): triangular, cow's face and jaw pose, tree pose, dance pose and plough pose.
While there are plenty of books around about yoga, it is as well to check with a qualified practitioner before starting yoga, as there have been occasions when more harm than good has been achieved, irrespective of what the yoga aficionados may claim.
The most popular activity is a daily brisk walk, if you are physically up to it, or at least two or three times a week. You don't have to beat the world walking record on your first day; depending on the extent of your arthritis, set yourself easy and attainable targets, such as a walk to the third lamp-post down the road. Then, after this has been achieved a few times, extend your range to the fourth, and so on.
Eventually, you can start timing yourself, so your walk quickens. Some arthritis sufferers swear that sweat lubricates their joints!
Always wear sensible shoes for walking, or trainers, and loose, comfortable clothing. Before starting your walk, do a few simple stretching exercises to warm up first.
Swimming is the ultimate low-impact exercise. And it's a medium that's not restricted to swimmers-non-swimmers can also benefit by just kicking their legs and making circular motions in the water with their arms.
Although it doesn't have the same bone-building qualities of walking or jogging, researchers say it does put enough force on the bones to strengthen them. A study by the Veterans Administration Medical Centre in Portland, Oregon examined men whose only exercise was swimming, and compared their bone density with men who did no exercise, and found that the swimmers had thicker bones.
Don't overdo it, however. Some found their arthritis worsened with the strenuous movements demanded of a swimming course. Instead, go at your own pace.
Some swear by cycling-either in the open air or on an exercise bike at home-while others swear at it for having worsened their arthritis. Again, it's all a question of knowing your own limitations, and being kind to yourself.
An ideal option for someone who isn't inclined to exercise regimes, but instead has always preferred pottering in the garden. Hoeing, weeding and light digging are all good bone-building activities that can help, provided you don't overdo things.
Gentle exercises at home
There's a range of gentle exercises you can do in your own living room, from stretching, rolling your head, pushing and pulling, that will all ease the joints. They've been taken from the book Arthritis: What Works (St Martin's Press) by Dava Sobel and Arthur Klein. Before starting any exercise, check with a qualified practitioner first.
For jaw pain: Mouth all the vowels-A-E-I-O-U-in an exaggerated manner to stretch the jaw muscles.
For neck pain: Do the head roll by tilting your head to the right as though you were trying to touch your ear to your shoulder, without lifting your shoulder. Then slowly circle your head forward until your chin reaches your chest. Then start circling back so that your left ear is close to your left shoulder. Finally, tilt your head back before returning to the normal position.
For shoulder pain: Stretch your shoulders by shrugging them, either one at a time or together.
For elbow pain: Let your arms rest straight down at your sides, with the palms facing the body. Bend and lift your elbows as you tuck your hands into your armpits. Also try to touch your thumbs to your shoulders.
For wrist pain: Rotate your wrist with your hand and forearm flat on a table or bed. Rotate your hand towards you as far as you can go, then rotate it back in the other direction.
For hand and finger pain: Rest your hand on a flat surface with the palm down. Spread your fingers as wide apart as they will go, then draw your fingers together again, keeping your hand flat.
For back pain: Lie on your back with your knees bent and feet flat. Bring one knee toward your chest as far as you can go. Return your knee to the starting position and then straighten your leg so it rests flat. Wobble your leg to relax, then return to the bent knee position. Repeat with the other leg.
For hip pain: Lie on your back, knees bent and feet flat. Straighten one leg and lift it as high as you can. Lower it slowly and repeat with the other leg.