Do you prioritize aerobic exercise over pharmacotherapy as the first active intervention in a patient with newly diagnosed fibromyalgia who has no prior treatment?

I use both in parallel as first-line agents. No one will improve if they're not moving (I use the word "movement" or "activity," rather than "exercise," as this could sound excessive to some folks). I only avoid pharmacotherapy if the pt. feels strongly against taking medications, but most people are just eager to get better and are willing to try anything to help. Re: exercise plan, I usually advise my patients to buy a fold-up stationary bike. Yes, this is a 1-time expense, but it folds up nicely into our small NY apartments, avoids the need for going outside in the snow or the summer humidity, there's no gym membership fee, and it has a very low activation threshold to get going: one needs to just open it, sit, and start pedaling! I usua...