Perspectives of sedentary behaviour, physical activity, and health messaging among people with fibromyalgia: a qualitative study

Objectives To explore how individuals with Fibromyalgia (FM) perceive physical activity (PA), sedentary behaviour (SB), and related health messaging. Methods UK-based adults (18+) with FM were recruited using maximum variation sampling from charities, social media support groups and research contacts. A constructivist qualitative approach was adopted, recognising that experiences and meanings are constructed through social context and interpretation. Semi-structured interviews were conducted virtually, informed by a behavioural model of Capability, Opportunity, and Motivation (COM-B) and the Theoretical Domains Framework (TDF). Public and Patient Involvement (PPI) contributed to the interview guide. Data were analysed using a reflexive thematic analysis to explore how participants interpreted sedentary behaviour, physical activity and health messaging. Results Fifteen participants (13 female, 2 male) aged 21–73 years (mean = 50.87, SD = 15.47) described complex, often conflicting experiences of PA and SB. Emotional responses like guilt, fear, and frustration influenced engagement with PA. Rest and activity were viewed as beneficial, however, balancing movement and rest were an ongoing challenge, influenced by fluctuating symptoms and external expectations. Participants highlighted a disconnect between clinical advice and lived experience, with terms like “sedentary” often perceived as unrelatable or stigmatising. Socioeconomic factors including limited access to personalised support and social rules, impacted engagement and contributed to feelings of stigma. Conclusion Participants reported emotional and practical challenges in balancing PA and SB, influenced by fluctuating symptoms, expectations and limited or unrelatable clinical advice. These findings highlight the need for personalised, inclusive, and context-sensitive movement advice that reflects lived experience to improve relevance and uptake.