I am a trauma survivor with chronic pain. My options for surgical relief and pain management have been exhausted as I refuse to have an internal pain pump and the Food and Drug Administration have denied my compassionate use request for dangerous neck and spinal surgery, because it is high risk and has a less than five percent chance of doing any good. Someone decided I might have fibromyalgia, but no one could explain to me what it was. The doctor mumbled something about maybe tai chi helping, and for me it did.

I later learned that fibromyalgia is a complex and confusing diagnosis that is thought to come from an overly aroused nervous system. This dysfunction can result in chronic, intermittent pain; sleep deprivation; and fatigue. These symptoms can trigger mental distress as well as cognitive and memory problems. There is no “one size fits all” approach. This makes finding useful treatment difficult.

The uncertainty and variation between patients that makes symptoms hard to treat, also make them challenging to research. Research can be enriched with patient and public involvement, and this is one way in which we as patients can show support for medical research. [1] In addition, interventions or treatments that show benefit are more likely to be reimbursed, and this is good for patients.

Tai chi is an ancient martial art that uses slow and gentle exercises to improve balance and mental calm in order to neutralise force and increase self regulation. My balance was poor from brain and spinal damage, and I could only see the depressing future of being a patient with chronic pain. I didn’t expect tai chi to work, but thought I’d give it a chance.

The typical regimen is an hour long class a day. This was the intervention used in a trial by Wang et al. Initially, I could only do ten minutes, three times a week, with constant supervision, because of memory and balance problems. Gradually, over about six weeks, my balance improved and this reduced anxiety and increased strength in my broken body. The ingrained philosophy of tai chi is to leverage force rather than resist it, and I still use this strategy regularly to manage pain.

Would I recommend tai chi for other patients with a fibromyalgia diagnosis? My answer is a qualified yes. These are some of the things you need to consider:

• make sure that you discuss it with your doctor first
• many instructors will offer you a free introductory class—use this to make sure it is a good match for you
• if the exercise hurts, stop and speak up—the instructor can show you how to adapt and if this does not help, it is best not to continue
• quality matters—the instructor will need to be trained and certified to teach people recovering from  injury
• consider the investment of your resources—the hour in class, transportation, costs—and balance these against benefit
• ask before you start how long it usually takes before students see a benefit
• some physiotherapy groups offer tai chi with other services, ask if this can be bundled for you as a reimbursed intervention if a doctor prescribes it.

Helpful, cost effective interventions like Tai Chi can be empowering as long as they are not used to deny other effective, but more costly, care. Tai chi has been reported as a safe form of exercise that improves functional capacity without making it hard to breathe or move for those with COPD, arthritis, and heart failure.(2) A recent systematic review showed that tai chi can reduce the incidence of falls in the elderly.[3] A systematic overview recommended tai chi as useful for older people for its various physical and psychological benefits.[4]

The caveat is that not all interventions work for everyone. Tai chi does not work for everyone with fibromyalgia. The advantage of the intervention is that it is low risk and minimally invasive, unlike surgery, and it will not harm your organs, like long term drug use. There is also the chance that it might complement other interventions to help your body work better.

• Read my review along with the linked research paper. You can sign up (www.bmj.com/about-bmj/resources-reviewers/guidance-patient-reviewers) to be a BMJ patient reviewer like me.

Amy Price worked as a neurocognitive rehabilitation consultant and in international missions before sustaining serious injury and years of rehabilitation. She emerged with a goal to build a bridge between research methodology and public research involvement where the public is trained and empowered to be equal partners in health research. Amy is The BMJ Patient Editor for Research and Evaluation, serves on the BMJ Patient Panel, and is reading for a DPhil in evidence based healthcare at the University of Oxford.

Competing interests: I have read and understood BMJ policy on declaration of interests and declare the following interests: None.

References:

1 Price A, Albarqouni L, Kirkpatrick J, et al. Patient and public involvement in the design of clinical trials: An overview of systematic reviews. Journal of Evaluation in Clinical Practice 2017:1-14.

2 Chen Y, Hunt MA, Campbell KL, et al. The effect of tai chi on four chronic conditions: cancer, osteoarthritis, heart failure, and chronic obstructive pulmonary disease: a systematic review and meta-analyses. Br J Sports Med 2016;50:397-407.

3 Lee MS, Ernst E. Systematic reviews of t’ai chi: an overview. British Journal of Sports Medicine 2011;46(10):713-8.

4 Lomas-Vega R, Obrero-Gaitán E, Molina-Ortega FJ, Del-Pino-Casado R. Tai chi for risk of falls: a meta-analysis. Journal of the American Geriatrics Society. 2017;65(9):2037-43.