The Role of Nutrient Supplementation in the Management of Chronic Pain in Fibromyalgia: A Narrative Review

Abstract

Introduction:The multifaceted clinical presentation of fibromyalgia (FM) supports the modern understanding of the disorder as a more global condition than one simply affecting pain sensation. The main pharmacologic therapies used clinically include anti-epileptics and antidepressants. Conservative treatment options include exercise, myofascial release, psychotherapy, and nutrient supplementation. Methods: Narrative review. Results: Nutrient supplementation is a broadly investigated treatment modality as numerous deficiencies have been linked to FM. Additionally, a proposed link between gut microbiome patterns and chronic pain syndromes has led to studies investigating probiotics as a possible treatment. Despite positive results, much of the current evidence regarding this topic is of poor quality, with variable study designs, limited sample sizes, and lack of control groups. Conclusions: The etiology of FM is complex, and has shown to be multi-factorial with genetics and environmental exposures lending influence into its development. Preliminary results are promising, however, much of the existing evidence regarding diet supplementation is of poor quality. Further, more robust studies are needed to fully elucidate the potential of this alternative therapeutic option.

Synbiotic Supplementation Improves Quality of Life and Inmunoneuroendocrine Response in Patients with Fibromyalgia: Influence of Codiagnosis with Chronic Fatigue Syndrome

“…In addition, as we have stated in previous research, particularly in young sedentary and sports people [ 38 , 39 ], probiotics, prebiotics and synbiotics could be beneficial for health, having positive repercussions on gastrointestinal health, immune and inflammatory response, as well as in other mental health parameters. However, there is little research on the use of probiotics in people diagnosed with FM and/or CFS [ 12 , 14 , 40 , 41 , 42 , 43 ] and even less after consumption of synbiotics. Thus, very interesting are the results of the present investigation showing that after ingesting a synbiotic for a period of 30 days, FM patients improved their mood, stress and anxiety levels, as well as the impact of the disease on their daily activities subjectively determined by validated questionnaires.…”

Efficacy of Acupuncture, Intravenous Lidocaine, and Diet in the Management of Patients with Fibromyalgia: A Systematic Review and Network Meta-Analysis

“…In addition to this, the role of diet has also been investigated as a treatment for FM, as there have been various linked deficiencies to FM. However, in spite of the encouraging results, this cannot be solid evidence, as much of the available regarding this topic had poor quality, different study designs, inadequate sample sizes, and absence of control groups [ 19 ].…”

Melatonin as a Mediator of the Gut Microbiota–Host Interaction: Implications for Health and Disease

“…Recently, the possible interplay between sleep deprivation, melatonin suppression and gut dysbiosis has been reviewed in relation to chronic orofacial pain, finding several connections that might be explored [226]. Probiotics (aimed at restoring the gut microbiota composition) and melatonin supplementation have been also explored as possible therapeutic options in the management of chronic pain in fibromyalgia [227].…”