Abstract

Background and Objectives: Regular exercise improves pain, fatigue, and overall function in individuals with fibromyalgia (FM), yet adherence remains low, especially among employed adults. This study examined symptom and workplace-related factors associated with exercise participation among employees with FM. Materials and Methods: A cross-sectional workplace survey was conducted across nine large employers (>100 employees) representing diverse occupational roles. Participants (n = 1044) reported FM diagnosis, exercise participation (≥3 sessions/week), perceived exercise barriers, sleep duration, and job-related stress. Comparisons were conducted between employees with and without FM, and within-group analyses explored exercise-related patterns among those with FM. Results: Forty-two participants (4.0%) reported a formal FM diagnosis. Compared with employees without FM, those with FM were older and reported significantly greater pain, fatigue, emotional stress and poorer sleep (all p < 0.01). Despite this increased symptom burden, rates of regular exercise did not differ between FM and non-FM employees (40.5% vs. 36.8%, p = 0.38). Within the FM group, exercisers and non-exercisers showed minimal observable differences in symptom severity. However, employees with FM reported shorter exercise session durations and identified sleep disruption, fatigue, and work-related demands as prominent barriers. Conclusions: Among employed adults with FM, symptom severity alone did not appear to distinguish those who engaged in regular exercise from those who did not. Instead, modifiable workplace and environmental barriers were indicated as key factors influencing exercise participation, emphasizing the need for occupationally informed strategies to support sustained physical activity in this population.