OSF Arthritis Services Exercise Specialist Lisa Hartwig has always been interested in wellness. After graduating from Illinois State University with a degree in exercise science, she started a career in Cardiac Rehabilitation at OSF Saint Francis Medical Center. “I loved helping people not only recover from a cardiac illness, but become healthier in the process,” she said.

This desire to help restore health has culminated in her current mission: to help those suffering from fibromyalgia. “In Cardiac Rehabilitation, I worked with individuals with many diseases, including fibromyalgia. And then I had the opportunity to help develop an exercise program for people with fibromyalgia,” Hartwig said. “This little-understood and often-dismissed illness eats away at every fiber of a person’s life until there’s little left. It affects their jobs, their relationships with family and friends, their ability to be productive, their ability to be present mentally to raise their children, and their ability to participate in hobbies. There’s just no energy to participate in day-to-day life, let alone be passionate about anything.”

She explained fibromyalgia affects 2 to 4 percent of the general population. “This translates to approximately 11,000 in our tri-county area, most of these being women. Fibromyalgia has never been easy to diagnose, nor does it have a definite cause. Many women experience years of frustration as they search for answers to why they’re having so much pain and fatigue, sleepless nights, headaches, memory loss, numbness, tingling, muscle cramps, dizziness, chest pain, anxiety, depression, irritable bowel and bladder problems, intolerance to cold or heat, and sensitivity to any and all stimuli. Treating fibromyalgia is as difficult as diagnosing it. Many treatments focus on improving the symptoms of each individual complaint, with varied success.”

Hartwig said exercise is widely recommended by physicians for treating fibromyalgia and has shown repeatedly to impact the symptoms of fibromyalgia significantly. “Proven benefits of exercise for those with fibromyalgia include less pain and fatigue, improved sleep, less stiffness, increased muscle strength and endurance, improved circulation, and decreased anxiety and depression. The catch is that getting to these benefits requires a long-term commitment and a very slow start. For example, one should start a walking program at two to three minutes a day, and gradually build up. This allows the body a chance to recover and strengthen more easily and also prevents the flare in symptoms that typically occurs when one has done too much. However, women with fibromyalgia often are told to exercise but are given very little guidance about what type of exercise and how much to do. Many decide to start out “slowly” with 15 or 20 minutes and then very quickly end up in bed because all of their symptoms have gotten worse. It seems hopeless. But when you take away all of the most damaging exercises and add in the right kinds in the right amounts, you can begin to experience relief and, over time, have significant improvement in the symptoms of fibromyalgia.”

And that’s where Hartwig comes in. In her work with the OSF Arthritis Program at the RiverPlex, she helps with the day-to-day operations of the arthritis programs, teaches classes in the warm-water pool and in the classroom for people with various forms of arthritis, and teaches Tai Chi classes. “’Fit & Strong…Lifelong’ exercise classes are 50 minutes long but move at a slow, relaxed pace. The purpose of the classes is to very slowly increase strength and stamina. The exercise room is quiet and low-lit, and soft music is played to help the muscles relax. All of the exercises can be done while sitting in a chair if necessary, and everyone is encouraged to work at her own pace.”

She also offers a more personalized consultation for those who would like to know exactly what they can do to improve their own symptoms. “I’ve found that while there are many core traits to fibromyalgia, each person has very different manifestations of the illness and each requires a very different approach to exercise. We’ve had many women through our program, and each has a unique situation—but the response in classes is usually the same. I see smiles and hear things like ‘I feel so much better’ (women with fibromyalgia never feel good and smiling is difficult—often forced) and ‘I finally know how to get my shoulders to relax’ (many people with fibromyalgia feel like they’ve grown their own football shoulder pads; this is how unrelaxed and painful the shoulders can be). Many participants are able to get a better quality of sleep, and some have been able to decrease the amount of pain and other medications they take.”

Another service offered, in conjunction with the Arthritis Foundation, is a support group for those with fibromyalgia, their family, and their friends. “This group meets once a month for an educational program and for time to share with each other,” Hartwig said. “The participants find a weight lifted when they hear others voice some of the same concerns and difficulties they’ve experienced for years. Typically, most with fibromyalgia have endured years of unaccepting attitudes from family, friends, co-workers, and medical persons who have expectations that don’t match the abilities of the person with fibromyalgia. Many have spent years in strained relationships and are lucky to have even one person to confide in who understands the struggles they face. Our Fibromyalgia Support Group has been a place for people to meet and form friendships with others who understand.”

Indeed, participants have only good things to say about the fibromyalgia programs. “It would be tempting to stay in bed when I feel sore and fatigued instead of getting ready to go to the Riverplex for the fibromyalgia class, but the class is one thing that entices me to not only get up and going, but to be early for the class,” said one participant. “I look forward to the class and our knowledgeable teacher, Lisa. If we ever have questions or concerns, she’ll help by answering those questions and/or finds resources to pass along. The relaxation techniques can be applied at any time or any place. Going weekly to the class helps me cope with the unpredictable changes that take place in my body. Each session I learn something new and helpful.”

Another participant said, “The program has been very helpful to me in managing my symptoms. I’ve been in the program for more than a year. Through Lisa’s help, leadership, interest, and instructions, I’ve found several ways to lessen all the difficulties associated with fibromyalgia. Each night before bed I spend about eight or nine minutes going through a Tai Chi warm-up routine Lisa taught us. I’m asleep within five minutes nearly every night. Tai Chi has made a tremendous difference in the quality of sleep I’m getting; therefore, I’m more alert and have much less daytime fatigue.”

Hartwig said there are two common misconceptions about fibromyalgia. “The first is that those with fibromyalgia are hypochondriacs. They tend to look as if nothing is wrong and yet go from doctor to doctor with this ailment and that ailment. What’s now understood about fibromyalgia is that there’s a dysfunction in the autonomic nervous system that causes a delay, absence, or abnormal communication in the body. For example, the body is supposed to experience pain if the arm is broken. When the autonomic nervous system is dysfunctional, a loud noise or a cold draft can be interpreted by the body as pain. To make matters worse, the body no longer feels pain where it’s occurring, but in the entire body. The other major misconception about fibromyalgia involves fatigue. When most people are asked to define ‘fatigue,’ they’ll say, ‘It’s being tired.’ When someone with fibromyalgia describes fatigue, it would sound something like this: ‘I feel like my body is suffocating’ or ‘I’m too tired to do anything but sit and stare at the wall.’ When you’re tired, you can rest and recover. When you’re fatigued, there’s no recovery, and once-loved activities are no longer an option.”

Although all sufferers need individual advice, she said some things are universal. “Keep reading and learning about fibromyalgia, keep your body moving, and be hopeful because there is hope.” TPW