Fibromyalgia

Aerobic Exercise Prescription for Pain Reduction in Fibromyalgia: A Systematic Review and Meta-Analysis.

Casanova-Rodríguez D, Ranchal-Sánchez A, Rodríguez RB, Jurado-Castro JM · European journal of pain (London, England) · 2025

Fibromyalgia is a condition characterised by disabling levels of pain of varying intensity. Aerobic exercise may play a role in reducing pain in these patients. The aim of this review is to assess the dose of aerobic exercise needed, based on the frequency, intensity, type, time, volume and progression (FITT-VP) model, to obtain clinically relevant reductions in pain. A systematic review and meta-analysis of randomised clinical trials was conducted in the Web of Science (WoS), PEDro, PubMed and Scopus databases, the search having been conducted between July and October of 2023. Risk of bias was assessed with the Cochrane Risk of Bias assessment tool 2. Seventeen studies were included. The risk of bias varied, with six studies showing low risk; five, some concerns; and six, high risk. Aerobic exercise interventions were analysed using the FITT-VP model. Frequency ranged from 1 to 10 times per week, intensity varied from light to vigorous, and the types of exercise included music-based

The most effective therapeutic exercises for pain intensity in women with fibromyalgia: A systematic review and network meta-analysis.

Rodríguez-Domínguez ÁJ, Rebollo-Salas M, Chillón-Martínez R, Rosales-Tristancho A, Villa-Del-Pino I, Jiménez-Rejano JJ · Brazilian journal of physical therapy · 2025 · n=2873

Therapeutic exercise (TE) is the only intervention with strong recommendation for fibromyalgia. However, there is controversy as to which type of exercise is the most beneficial. To determine which TE approach is the most effective in reducing pain intensity in women with fibromyalgia. A systematic review was performed with a network meta-analysis (NMA). Six databases were searched from inception until January 2024. Randomized controlled trials (RCTs) evaluating the effects of TE on pain intensity were included in women with fibromyalgia. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The size of the effect and the clinically important difference were determined in the short-term (≤3 months) and long-term (>3 months). Sixty-one studies were identified, of which 51 were included in the quantitative synthesis (n = 2873). Fifteen TE interventions and eight comparison interventions (comparators) were identified. Aquatic exercise (p-score:

Efficacy and safety of gut microbiota-based therapies in autoimmune and rheumatic diseases: a systematic review and meta-analysis of 80 randomized controlled trials.

Zeng L, Yang K, He Q, Zhu X, Long Z, Wu Y · BMC medicine · 2024

Previous randomized controlled trials (RCTs) suggested that gut microbiota-based therapies may be effective in treating autoimmune diseases, but a systematic summary is lacking. Pubmed, EMbase, Sinomed, and other databases were searched for RCTs related to the treatment of autoimmune diseases with probiotics from inception to June 2022. RevMan 5.4 software was used for meta-analysis after 2 investigators independently screened literature, extracted data, and assessed the risk of bias of included studies. A total of 80 RCTs and 14 types of autoimmune disease [celiac sprue, SLE, and lupus nephritis (LN), RA, juvenile idiopathic arthritis (JIA), spondyloarthritis, psoriasis, fibromyalgia syndrome, MS, systemic sclerosis, type 1 diabetes mellitus (T1DM), oral lichen planus (OLP), Crohn's disease, ulcerative colitis] were included. The results showed that gut microbiota-based therapies may improve the symptoms and/or inflammatory factor of celiac sprue, SLE and LN, JIA, psoriasis, PSS, MS

Aquatic Exercise in Physical Therapy Treatment for Fibromyalgia: Systematic Review.

Rodríguez-Huguet M, Ayala-Martínez C, Góngora-Rodríguez P, Rosety-Rodríguez MÁ, Martín-Valero R, Góngora-Rodríguez J · Healthcare (Basel, Switzerland) · 2024

Fibromyalgia is a chronic condition characterized by musculoskeletal pain. The aim of this study was to synthesize scientific evidence on the effects of aquatic exercise programs on pain and quality of life in individuals with fibromyalgia. This review was carried out using the following databases in January 2024: Cochrane Library, PEDro, PubMed, SCOPUS, and Web of Science. Four clinical trials focusing on aquatic exercise as a treatment for patients with fibromyalgia were selected. These trials were published in English between 2019 and 2024. Pain recorded using the Visual Analog Scale (VAS) and quality of life with the Short Form-36 Health Survey (SF-36) or Fibromyalgia Impact on Quality of Life (FIQ) were the most commonly analyzed variables. This review was carried out according to the PRISMA statement and was registered in PROSPERO (CRD42024510219). The results in terms of pain and quality of life were positive. In conclusion, these findings support the incorporation of aquatic ex

Efficacy of physiotherapy treatment in medium and long term in adults with fibromyalgia: an umbrella of systematic reviews.

Carrasco-Vega E, Guiducci S, Nacci F, Bellando Randone S, Bevilacqua C, Gonzalez-Sanchez M · Clinical and experimental rheumatology · 2024

To summarise the available evidence and assess the effectiveness of medium and long-term physiotherapy treatment in adults with fibromyalgia (FM). This systematic review was registered in PROSPERO: CRD42023388356. The databases searched were MEDLINE, PEDro, Scopus, Cinhal, LatinIndex, and Cochrane, using the following keywords: "fibromyalgia", "physiotherapy", "treatment", "therapeutic exercise", "TENS", "laser therapy" and "manual therapy." The included articles analysed treatments with active or passive physiotherapy approaches in patients with FM. The variables included structural characteristics, such as: author, publication year, research question, and main outcome variables. The data on the findings of the articles comprised the following aspects: number of participants, intervention, follow-up, results, and principal conclusions. Thirty-three articles were analysed, with an overall PRISMA score of 18.63±3.36. The active treatment methods analysed were: movement and body a

Cannabis for the Treatment of Fibromyalgia: A Systematic Review.

Strand NH, Maloney J, Kraus M, Wie C, Turkiewicz M, Gomez DA · Biomedicines · 2023 · n=564

Fibromyalgia is a common disease syndrome characterized by chronic pain and fatigue in conjunction with cognitive dysfunction such as memory difficulties. Patients currently face a difficult prognosis with limited treatment options and a diminished quality of life. Given its widespread use and potential efficacy in treating other types of pain, cannabis may prove to be an effective treatment for fibromyalgia. This review aims to examine and discuss current clinical evidence regarding the use of cannabis for the treatment of fibromyalgia. An electronic search was conducted on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus using Medical Subject Heading (MeSH) terms on all literature published up to October 2022. A follow-up manual search included a complete verification of relevant studies. The results of four randomized controlled trials (RCTs) and five observational studies (a total of 564 patients) that investigated

Guidelines on Treating Fibromyalgia With Nonpharmacological Therapies in China.

Li X, Pan H, Wang L, Zhou Q, Ma Y, Wang Q · Journal of evidence-based medicine · 2025

Fibromyalgia is a prevalent chronic condition marked by widespread pain, fatigue, and other debilitating symptoms. This guideline provides evidence-based recommendations for nonpharmacological treatments, developed by a multidisciplinary expert group, including specialists in rheumatology, rehabilitation, pain management, traditional Chinese medicine (TCM), and evidence-based medicine. The guideline follows the RIGHT checklist and is registered with the International Practice Guideline Registry Platform. The literature review incorporates systematic reviews, meta-analyses, and randomized controlled trials (RCTs) up to March 2023, focusing on the effects of nonpharmacological interventions on pain intensity, fatigue, sleep quality, mood, and quality of life. A total of 57 studies were included, with findings supporting acupuncture and health education as core therapies. These interventions significantly reduce pain, alleviate fatigue, and improve sleep quality, and are strongly recommen

EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis.

Nagy G, Roodenrijs NMT, Welsing PMJ, Kedves M, Hamar A, van der Goes MC · Annals of the rheumatic diseases · 2022

To develop evidence-based European Alliance of Associations for Rheumatology (EULAR) points to consider (PtCs) for the management of difficult-to-treat rheumatoid arthritis (D2T RA). An EULAR Task Force was established comprising 34 individuals: 26 rheumatologists, patient partners and rheumatology experienced health professionals. Two systematic literature reviews addressed clinical questions around diagnostic challenges, and pharmacological and non-pharmacological therapeutic strategies in D2T RA. PtCs were formulated based on the identified evidence and expert opinion. Strength of recommendations (SoR, scale A-D: A typically consistent level 1 studies and D level 5 evidence or inconsistent studies) and level of agreement (LoA, scale 0-10: 0 completely disagree and 10 completely agree) of the PtCs were determined by the Task Force members. Two overarching principles and 11 PtCs were defined concerning diagnostic confirmation of RA, evaluation of inflammatory disease activity, pharm

The Italian Society for Rheumatology clinical practice guidelines for the diagnosis and management of fibromyalgia Best practices based on current scientific evidence.

Ariani A, Bazzichi L, Sarzi-Puttini P, Salaffi F, Manara M, Prevete I · Reumatismo · 2021

Fibromyalgia or fibromyalgia syndrome (FMS) is defined as a central sensitization syndrome characterized by the dysfunction of neurocircuits detecting, transmitting and processing nociceptive stimuli; the prevalent manifestation is musculoskeletal pain. In addition to pain, there are multiple accompanying symptoms, in common with other algo-dysfunctional syndromes, which are reflected in a broad spectrum of somatic, neurocognitive and neuro-vegetative manifestations. An evidence-based approach is essential in FMS management, in order to improve patient health and to reduce its social burden. Since in the last ten years new international guidelines for clinical practice (Clinical Practice Guidelines or CPGs) concerning FMS diagnosis and pharmacological/ non-pharmacological management have been published, the Italian Society of Rheumatology (SIR) has decided to adapt them to the Italian national setting. The framework of the Guidelines International Network Adaptation Working Group was a

Beyond the Pain: A Systematic Narrative Review of the Latest Advancements in Fibromyalgia Treatment.

Ram PR, Jeyaraman M, Jeyaraman N, Nallakumarasamy A, Khanna M, Gupta A · Cureus · 2023

Fibromyalgia is a complex chronic pain disorder that significantly impacts the quality of life of affected individuals. The etiology of fibromyalgia remains elusive, necessitating effective treatment options. This review aims to provide an overview of current treatment options for fibromyalgia and highlight recent updates in managing the condition. The methodology employed in this systematic review comprised the following key steps. We conducted a comprehensive search across various databases to identify pertinent studies published between 2000 and 2023. Inclusion criteria were defined to specifically target studies involving adult individuals diagnosed with fibromyalgia, with a focus on both pharmacological and non-pharmacological interventions for managing the condition. The review encompassed a range of study types, including randomized controlled trials, observational studies, and systematic reviews. To ensure the quality of the selected studies, we employed appropriate assessment

Duloxetine for fibromyalgia syndrome: a systematic review and meta-analysis.

Migliorini F, Maffulli N, Eschweiler J, Baroncini A, Bell A, Colarossi G · Journal of orthopaedic surgery and research · 2023 · n=10

The optimal dose of duloxetine in the management of fibromyalgia remains still controversial. Therefore, a systematic review and meta-analysis to investigate efficacy and safety of duloxetine was conducted. The outcomes of interests were to assess changes in Fibromyalgia Impact Questionnaire (FIQ), Brief Pain Inventory (BPI), and Clinical Global Impression (CGI). The rate of of adverse events and those leading to therapy discontinuation were also investigated. This study followed the 2020 PRISMA guidelines. The literature search started in December 2022 accessing PubMed, Google scholar, Embase, and Scopus databases. All the RCTs investigating the efficacy and safety of daily administration of duloxetine for fibromyalgia were accessed. Studies reporting quantitative data under the outcomes of interest, and including a minimum of 10 patients who completed a minimum of 4 weeks follow-up, were included. Studies on combined pharmacological and non-pharmacological managements for fibro

Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders.

Fregni F, El-Hagrassy MM, Pacheco-Barrios K, Carvalho S, Leite J, Simis M · The international journal of neuropsychopharmacology · 2021

Transcranial direct current stimulation has shown promising clinical results, leading to increased demand for an evidence-based review on its clinical effects. We convened a team of transcranial direct current stimulation experts to conduct a systematic review of clinical trials with more than 1 session of stimulation testing: pain, Parkinson's disease motor function and cognition, stroke motor function and language, epilepsy, major depressive disorder, obsessive compulsive disorder, Tourette syndrome, schizophrenia, and drug addiction. Experts were asked to conduct this systematic review according to the search methodology from PRISMA guidelines. Recommendations on efficacy were categorized into Levels A (definitely effective), B (probably effective), C (possibly effective), or no recommendation. We assessed risk of bias for all included studies to confirm whether results were driven by potentially biased studies. Although most of the clinical trials have been designed as proof-of-

Fibromyalgia

NHS

The NHS website offers a detailed overview of fibromyalgia, including its symptoms, causes, diagnosis, and available treatments. It aims to provide clear and reliable health information to the UK public.

Fibromyalgia: In Depth

NIH NCCIH

This page from NCCIH provides in-depth information on fibromyalgia, including conventional treatments and the science behind complementary health approaches. It discusses the evidence for various integrative therapies.

Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Multi-Center Trial Comparing the Effects of Orally Administered Xyrem(R) (Sodium Oxybate) With Placebo for the Treatment of Fibromyalgia

n=195 · NCT00087555 · COMPLETED · COMPLETED

The purpose of this study is to determine whether Xyrem (sodium oxybate) is effective when used alone to treat the pain and sleep disturbances of fibromyalgia.

EEG Alpha Rhythm Modulation Using Sham Neurofeedback During Attentional Control in a Virtual Reality Environment

n=35 · NCT06748976 · RECRUITING · RECRUITING

The goal of this study is to determine whether an open-loop sham neurofeedback system can effectively modulate EEG alpha rhythms, which are associated with attentional control. The main questions it aims to answer are: Does positive sham neurofeedback lead to a decrease in relative EEG alpha power compared to a control condition without feedback? Researchers will compare the effects of positive and negative sham-neurofeedback conditions to a control condition without feedback to assess the system's impact on alpha rhythm modulation. Participants will: Experience three conditions (positive sham-neurofeedback, negative sham-neurofeedback, and no feedback) within a virtual reality environment. Undergo EEG recordings to measure changes in alpha power as a marker of attentional resource allocation. Provide written informed consent and complete the study following ethical guidelines. This study seeks to explore the potential of open-loop feedback systems to enhance attentional control by modulating alpha rhythm.

Fibromyalgia Activity Study With Transcutaneous Electrical Nerve Stimulation

n=301 · NCT01888640 · COMPLETED · COMPLETED

Pain associated with fibromyalgia interferes with daily function, work, and social activities resulting in a decreased quality of life. People with fibromyalgia also have a significant amount of fatigue and a fear of movement. People with fibromyalgia show enhanced excitability of pain neurons in the central nervous system and reduced pain inhibition. Therefore, one of the main treatments for patients with fibromyalgia must focus on pain relief to allow the person to function more independently both at home and at work. Transcutaneous electrical nerve stimulation is used by health professionals to deliver electrical stimulation through the skin for pain control. Basic science studies, from the PI's laboratory show that TENS activates descending pain inhibitory pathways to inhibit excitability of pain neurons. Thus the ideal patient population for the treatment of TENS would be one in which there is enhanced central excitability and reduced inhibition; fibromyalgia is such a condition. Hypothesis: The investigators hypothesize that application of Transcutaneous Electrical Nerve Stimulation (TENS) to patients with fibromyalgia will reduce resting and movement-related pain and reduce central excitability by restoring diffuse noxious inhibitory controls (DNIC), and that this decrease in pain and/or central excitability will reduce fatigue and fear of movement, thereby improving function and quality of life

Cochrane reviews on fibromyalgia

Cochrane

The Cochrane Library provides a collection of systematic reviews on various treatments and interventions for fibromyalgia. It offers high-quality evidence to inform healthcare decisions.

TRIP Database search results for Fibromyalgia

TRIP Database

TRIP is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support clinical practice and care. Searching for fibromyalgia yields various guidelines, systematic reviews, and evidence-based synopses.