Effectiveness of non-pharmacological conservative therapies in adults with fibromyalgia: A systematic review of high-quality clinical trials

Abstract

BACKGROUND: Fibromyalgia is a chronic condition characterized by generalized pain. Several studies have been conducted to assess the effects of non-pharmacological conservative therapies in fibromyalgia. OBJECTIVE: To systematically review the effects of non-pharmacological conservative therapies in fibromyalgia patients. METHODS: We searched MEDLINE, Cochrane library, Scopus and PEDro databases for randomized clinical trials related to non-pharmacological conservative therapies in adults with fibromyalgia. The PEDro scale was used for the methodological quality assessment. High-quality trials with a minimum score of 7 out of 10 were included. Outcome measures were pain intensity, pressure pain threshold, physical function, disability, sleep, fatigue and psychological distress. RESULTS: Forty-six studies met the inclusion criteria. There was strong evidence about the next aspects. Combined exercise, aquatic exercise and other active therapies improved pain intensity, disability and physical function in the short term. Multimodal therapies reduced pain intensity in the short term, as well as disability in the short, medium and long term. Manual therapy, needling therapies and patient education provided benefits in the short term. CONCLUSIONS: Strong evidence showed positive effects of non-pharmacological conservative therapies in the short term in fibromyalgia patients. Multimodal conservative therapies also could provide benefits in the medium and long term.

Análisis de los programas de ejercicio acuático en personas con fibromialgia (Analysis of aquatic exercise programmes for people with fibromyalgia)

“…De la misma forma, el EA se muestra efectivo en la reducción de discapacidad a largo plazo, al igual que en la mejora del sueño, factor que es resaltado en la mayoría de los artículos analizados. Por otro lado, en la revisión realizada por Hernando-Garijo et al, (2022), se muestra que las terapias con EA respiratorio y aeróbico combinado con técnicas de estiramientos, son efectivas para la reducción de la ansiedad a corto plazo. Sin embargo, tan solo el manuscrito de Ide et al, (2008) analiza este aspecto, con un programa de ejercicio respiratorio acuático, que, a corto plazo, mejora la ansiedad.…”

The role of mind body interventions in the treatment of irritable bowel syndrome and fibromyalgia

“…Although the mechanism behind such psychological interventions is unclear, an improvement in illness-specific thoughts, beliefs and perceptions or cognitive bias has been postulated (73). In both IBS and FM, CBT results in decreased symptom severity, improved mental health and quality of life (32,65,68,(74)(75)(76)(77)(78)(79).…”

What Concept of Manual Therapy Is More Effective to Improve Health Status in Women with Fibromyalgia Syndrome? A Study Protocol with Preliminary Results

“…There is high evidence of treatment combining exercise, aquatic exercise, other active therapies and multimodal therapies, on improving pain intensity, disability and physical function in the short term. In addition, manual therapy, needle therapies and patient education also provide short-term benefits [13].…”