Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia

Abstract

The objectives of the study were identification, quality evaluation and summary of RCTs on complementary and alternative medicine as defined by the National Institute of Health with the exception of dietary and nutritional supplements. A computerized search of databases from 1990 (year of publication of the ACR criteria for fibromyalgia) to July 2007 was performed. The RCTs were assessed by a methodological quality score. A total of 23 RCTs issued from 1992 to 2007 on acupuncture, balneotherapy, thermotherapy, magnetic therapy, homeopathy, manual manipulation, mind-body medicine, diet therapy and music therapy were identified. The RCTs had an average group size of 25 with the number of groups ranging from two to four. The quality score assessment of the RCTs yielded a mean score of 51 out of 100. The average methodological quality of the identified studies was fairly low. Best evidence was found for balneotherapy/hydrotherapy in multiple studies. Positive results were also noted for homeopathy and mild infrared hyperthermia in 1 RCT in each field. Mindfulness meditation showed mostly positive results in two trials and acupuncture mixed results in multiple trials with a tendency toward positive results. Tendencies for improvement were furthermore noted in single trials of the Mesendieck system, connective tissue massage and to some degree for osteopathy and magnet therapy. No positive evidence could be identified for Qi Gong, biofeedback, and body awareness therapy.

Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report

“…Fibromyalgia Three medium quality systematic reviews [133-135] assessed manual therapy in patients with fibromyalgia. However, two reviews [133,134] did not include studies not already included in the UK evidence report and both concluded that there is insufficient evidence to support the effectiveness of manual therapy in the treatment of fibromyalgia.…”

Mindfulness-Based Therapies in the Treatment of Somatization Disorders: A Systematic Review and Meta-Analysis

“…Baranowsky et al [32] included Astin et al [27] and Sephton et al's [30] studies in a non-meta-analytic review. The two studies together suggested small but significant positive effects in reduction of pain intensity and depression.…”

Inhaled hydrogen sulfide prevents neuropathic pain after peripheral nerve injury in mice

“…Balneotherapy in sulfur containing hot water has been widely used for the treatment of chronic pain associated with a number of conditions including osteoarthritis and fibromyalgia [36–38]. While the mechanisms responsible for the beneficial effects of balneotherapy are poorly understood, it has been reported that immersion in sulfur-rich hot water increases serum cysteine levels [39] while decreasing plasma levels of inflammatory cytokines and reactive oxygen species [40].…”