A 2017 cochrane summary concluded that aerobic exercise probably improves quality of life, slightly decreases pain and improves physical function and makes no difference in fatigue and stiffness. A 2019 meta-analysis showed that exercising aerobically can reduce autonomic dysfunction and increase heart rate variability. This happens when patients exercise at least twice a week, for 45–60 minutes at about 60%-80% of the maximum heart rate. Aerobic exercise also decreases anxiety and depression and improves the quality of life. Flexibility
Combinations of different exercises such as flexibility and aerobic training may improve stiffness. However, the evidence is of low-quality. It is not clear if flexibility training alone compared to aerobic training is effective at reducing symptoms or has any adverse effects. Resistance
In resistance exercise, participants apply a load to their body using weights, elastic band, body weight or other measures. Two meta-analyses on fibromyalgia have shown that resistance training can reduce anxiety and depression and one found that it improves quality of life.The dosage of resistance exercise for women with fibromyalgia was studied in a 2022 meta-analysis. Effective dosages were found when exercising twice a week, for at least eight weeks. Symptom improvement was found for even low dosages such as 1–2 sets of 4–20 repetitions. Most studies use moderate exercise intensity of 40% to 85% one-repetition maximum. This level of intensity was effective in reducing pain. Some treatment regimes increase the intensity over time (from 40% to 80%), whereas others increase it when the participant is able to perform 12 repetitions.
Fibromyalgia is associated with mental health issues like anxiety, posttraumatic stress disorder, bipolar disorder, and depression. Patients with fibromyalgia are five times more likely to have major depression than the general population.Fibromyalgia and numerous chronic pain conditions frequently coexist. These include chronic tension headaches, myofascial pain syndrome, and temporomandibular disorders. Multiple sclerosis, post-polio syndrome, neuropathic pain, and Parkinsons disease are four neurological disorders that have been linked to pain or fibromyalgia. Fibromyalgia largely overlaps with chronic fatigue syndrome and may share the same pathogenetic mechanisms.Comorbid fibromyalgia has been reported to occur in 20–30% of individuals with rheumatic diseases. It has been reported in people with noninflammatory musculoskeletal diseases.The prevalence of fibromyalgia in gastrointestinal disease has been described mostly for celiac disease and irritable bowel syndrome (IBS). Fibromyalgia has also been linked with obesity. Other conditions that are associated with fibromyalgia include an overactive bladder. Risk factors
The cause of fibromyalgia is unknown. However, several risk factors, genetic and environmental,  have been identified. Genetics
Genetics play a major role in fibromyalgia, and may explain up to 50% of the disease susceptibility. Fibromyalgia is potentially associated with polymorphisms of genes in the serotoninergic, dopaminergic and catecholaminergic systems. Several genes have been suggested as candidates for susceptibility to fibromyalgia. These include SLC64A4, TRPV2, MYT1L, NRXN3, and the 5-HT2A receptor 102T/C polymorphism.