Carmen Gota, MD, director of the Fibromyalgia Clinic at Cleveland Clinic in Ohio, is not surprised. “The problem with creatine in this study is that it improved muscle performance a little bit, but it did not improve fibromyalgia because it’s treating the effect and not the cause. If you do not treat the cause, you’re not going to get better.”

Dr. Gota believes that the muscle dysfunction seen in fibromyalgia may be linked to chronic, sustained stress. “In people who are under chronic stress, the sympathetic nervous system – the fight-or-flight stress response – functions excessively. I think that reflects on all the organs in the body and is involved also in the muscle tone. So helping the muscles a little bit is good, but it’s not going to solve your problem,” she says.

Exercise is also critically important for fighting fibromyalgia, says Dr. Gota, “but the exercise has to be gradual.” She warns that if people do too much too soon, they hurt more and they’re tired the next day.

She advises starting with just five minutes a day for a month, doing 10 minutes a day the next month – and sticking with it. “With something that took years to accumulate, you’ll need at least a year or two to get better,” she says.

The length of the study might be another reason for the negative results, according to Dr. Gota. “The reason a lot of people say ‘nothing works’ is because a lot of the studies and interventions are short-term. This study might have shown more benefit if [it] had been done over a year. That’s true with other studies as well.”

Does she advise taking creatine supplements to help strengthen muscles so you can exercise more? “It’s not a bad idea, and I’m not saying that it doesn’t help a little bit. I’m saying that as a sole treatment, it’s not going to work.”

Dr. Gota adds, “Even in athletes, you’re not going to increase muscle bulk [only] by taking creatine. You still have to exercise.”