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Nonpharmacologic approaches can improve fibromyalgia symptoms
Clinical Question
What nonpharmacologic treatments are effective for patients with fibromyalgia?
Bottom line
Nonpharmacologic treatments can improve symptoms in patients with fibromyalgia. But one size doesn't fit all: exercise benefits fatigue and sleep; psychological treatments affect pain, sleep, and depression. Thermal baths, massage, and combinations of therapy also benefit overall scores. 1a-
Reference
Study design: Meta-analysis (randomized controlled trials)
Funding: Government
Setting: Various (meta-analysis)
Synopsis
To find all relevant research, these researchers searched 6 databases, Google Scholar, and reference lists of previous systematic reviews. They identified 167 randomized controlled trials that compared 22 nonpharmacologic interventions with usual care, placebo, or sham treatment. Study quality was not great — most studies were open (patients, who were also the evaluators, knew they which treatment they were receiving) and there was a high likelihood that publication bias occurred. Using the Fibromyalgia Impact Questionnaire (FIQ) as the primary outcome measure, exercise, psychological treatments, balneotherapy (thermal baths), and massage were all effective. Combining exercise intervention, patient education, and psychological treatment was also effective. Some results were heterogeneous across the studies: All forms of exercise improve pain, and mind-body and strengthening exercises improve fatigue. Aerobic and strengthening exercises improve sleep. Cognitive behavioral therapy and mindfulness improve overall FIQ scores, pain, sleep, and depression scores.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Fibromyalgia
Il est au moins satisfaisant que les programmes d’exercices et des traitements psychologiques aident les patients atteints de fibromyalgies
Alternate treatments for Fibromyalgia.
I have always thought there was a strong cerebral contribution to Fibromyalgia, and this report seems to suggest a supratentorial cause in some cases. Back in the dark ages when I was in Med School ( the 1980's ) an alternate name for it was "Myalgic Encephalopoly"
Fibromyalgia treatments
A meta-analysis of studies highly subject to bias will result in observations that are highly subject to bias. Not going to use this meta-analysis or paper for any clinical decision making.
FM
I agree those nonpharmacologic treatments are beneficial
But access an cost and coverage are an issue for many
non medical rx's for FM
several nonmed rx's have been succesful