Pain Education and Therapeutic Exercise for Fibromyalgia

Fibromyalgia syndrome is characterized by chronic generalized musculoskeletal pain associated with fatigue, sleep disturbances and psychological problems. The European League Againts Rheumatism (EULAR) described an algorithm how to treat step by step these patients. The objective of this trial is to evaluate if patient education plus therapeutic exercise is more effective in pain intensity, fatigue, function, strength, pain threshold, anxiety, depression, quality of life, quality of sleep, kinesiophobia, pain coping and biochemical and genetic markers and compared to therapeutic exercise. For this purpose the investigators conduct a randomized controlled trial double-blind (patient and examiner). The investigators included patients diagnosed of fibromyalgia according to the American College of Rheumatology (ACR). Patients included are randomized into 2 groups one receive education of pain neurophysiology plus exercise therapy and the other only exercise therapy. Groups receive 3 treatment sessions a week over 10 weeks. The variables are measured at the beginning and end of treatment. And also some variables are measured before and after each session.

Pain education according to the book "Explain Pain" written by Lorimer Moseley and David Butler Exercise therapy based primarily in aerobic exercise according clinical guidelines last recommendations.

Exercise therapy based primarily in aerobic exercise according clinical guidelines last recommendations.

To explain the physiology of nervous system and the mechanism and modulation of acute and chronic pain. To perform different whole body aerobic exercises with a mild to moderate intensity according to Borg scale and maximum heart rate.

To perform different whole body aerobic exercises with a mild to moderate intensity according to Borg scale and maximum heart rate.

The investigators measure the intensity of pain with a Visual Analogic Scale (VAS) pre-intervention at baseline

The investigators measure the intensity of pain with a Visual Analogic Scale (VAS) at the end of the intervention

The investigators measure the impact of Fibromyalgia syndrome by Fibromyalgia Impact Questionnaire R (FIQ-R) pre-intervention at baseline

The investigators measure the impact of Fibromyalgia syndrome by Fibromyalgia Impact Questionnaire R (FIQ-R) at the end of the intervention

The investigators measure the fatigue with Multidimensional Fatigue Inventory (MFI-S) pre-intervention at baseline

The investigators measure the fatigue with Multidimensional Fatigue Inventory (MFI-S) at the end of the intervention

The investigators measure the quality of sleep with Pittsburg Sleeping Questionnaire Index (PSQI) at baseline

The investigators measure the quality of sleep with Pittsburg Sleeping Questionnaire Index (PSQI) at the end of the intervention

The investigators measure the strength of arms with handgrip test, elbow flexion and knee extension with handheld dynamometer at baseline

The investigators measure the strength of arms with handgrip test, elbow flexion and knee extension with handheld dynamometer at the end of treatment

The investigators measure the pressure pain threshold of the 18 points described initially by the American College of rheumatology with a digital algometer at baseline

The investigators measure the pressure pain threshold of the 18 points described initially by the American College of rheumatology with a digital algometer at the end of treatment

The investigators measure the anxiety and depression with Hospital Anxiety and Depression Scale (HADS) at baseline

The investigators measure the anxiety and depression with Hospital Anxiety and Depression Scale (HADS) at the end of the intervention

The investigators measure the quality of life with ( Health Assessment Questionnaire (HAQ) at the end of treatment

The investigators measure the central sensitization with Chronic Pain Self-Efficacy Scale (CPSS) at baseline

The investigators measure the central sensitization with Chronic Pain Self-Efficacy Scale (CPSS) at the end of treatment

Inclusion Criteria: Diagnosed medically with Fibromyalgia Diagnosed according to the American College of Rheumatology criteria Agreement to attend to treatment sessions Exclusion Criteria: Any kind of contraindications for physical activity Other kind of diseases that could limit the intervention Previous surgery last year Medication modifications in the last 3 months

The patient data were confidential and were assigned a number to each patient to maintain confidentiality