Review of complementary and alternative medicine treatments in Fibromyalgia Syndrome

An article e-published ahead of print in the journal Rheumatology International has reviewed the published evidence for complementary and alternative medicine in the treatment of Fibromyalgia Syndrome and found that there is best evidence for the use of balneotherapy/hydrotherapy.

The objectives of the study were identification, quality evaluation and summary of randomised controlled trials (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 Syndrome) to July 2007 was performed. The RCTs found in this search 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 and the researchers found that 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.

References:

1. Baranowsky J, Klose P, Musial F, Haeuser W, Dobos G, Langhorst J. Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. Rheumatol Int. 2009 Aug 12. [Epub ahead of print]