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Fibromyalgia

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Related Terms

FibrositisFibromyositisMyofascial Pain SyndromeMyofibrositisPrimary Fibromyalgia Syndrome

Fibromyalgia is a disorder that causes widespread pain in the body. It also causes poor sleep and fatigue. These symptoms can make it hard to do daily tasks. The cause is not known.

It is treated by controlling symptoms. This is done using therapy, lifestyle changes, and medicine. Some people look to natural therapies to further ease pain.

Natural Therapies

Likely Effective

  • Acupuncture uses fine needs on specific body parts to ease fibromyalgia pain. A1-A8

May Be Effective

Mind/body therapies that may be effective include:

  • Biofeedback helps you learn to control your body’s functions, such as pain.G11, G14
  • Guided imagery uses the imagination to help relax your mind and body.G3, G4, G10, G13, G14
  • Hypnosis places you in a sleeplike state during which you can accept suggestions made by the therapist.G7, G15
  • Tai chi is a Chinese discipline that uses slow movements to improve the health of the mind and body.G1, G6, G8, G16
  • Yoga uses breath control, meditation, and poses to help you relax.G2, G5, G8, G9,

Supplements that may be effective are:

  • Melatonin is a hormone that plays a role in sleep.I3, I4
  • Traditional Chinese medicine is an herbal style of medicine that has been used for thousands of years to prevent, diagnose, and treat health problems.I2

Other therapies that may be effective are:

  • Balneotherapy treats fibromyalgia pain with bath treatments.B1-B5 (Note: Balneotherapy may use excessive heat. This may be harmful to certain people.)
  • Brain stimulation uses electricity to regulate abnormal brain impulses.C1-C4
  • Capsaicin is the burning heat that comes from chili peppers.H1
  • Magnet therapy places magnets on the body to relieve pain.D1
  • Manual therapy treats pain by manipulating joints and tissue. Chiropractic care is one example.E1-E4
  • Massage therapy manipulates soft tissues to ease pain.F1-F3

Unlikely to Be Effective

  • Cannabinoids are chemical compounds from marijuana.I1, I5, I6 (Note: Cannabinoids may weaken the immune system.)

Not Enough Data to Assess

  • Transcutaneous electrical nerve stimulation (TENS) H2
  • Thermal therapy H3

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some may get in the way of treatment. They can also make illness worse or cause new problems. Examples include:

  • Balneotherapy may use excessive heat. This may be harmful to pregnant women, people with heart or other medical conditions, and people under the influence of drugs or alcohol.
  • Cannabinoids may weaken the immune system. This might make it harder for your body to fight infections.
 

References►

Acupuncture

A1. Langhorst J, Klose P, et al. Efficacy of acupuncture in fibromyalgia syndrome--a systematic review with a meta-analysis of controlled clinical trials. Rheumatology (Oxford). 2010 Apr;49(4):778-788.

A2. Deare JC, Zheng Z, et al. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev. 2013 May 31;(5):CD007070.

A3. Weber A, Werneck L, et al. Effects of music in combination with vibration in acupuncture points on the treatment of fibromyalgia. J Altern Complement Med. 2015 Feb;21(2):77-82.

A4. Vas J, Santos-Rey K, Navarro-Pablo R, et al. Acupuncture for fibromyalgia in primary care: a randomised controlled trial. Acupunct Med. 2016;34(4):257-266.

A5. Ugurlu FG, Sezer N, et al. The effects of acupuncture versus sham acupuncture in the treatment of fibromyalgia: a randomized controlled clinical trial. Acta Reumatol Port. 2017 Jan-Mar;42(1):32-37.

A6. Perry R, Leach V, et al. An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools. Syst Rev. 2017 May 15;6(1):97.

A7. Li X, Wang R, et al. Acupuncture for Myofascial Pain Syndrome: A Network Meta-Analysis of 33 Randomized Controlled Trials. Pain Physician. 2017 Sep;20(6):E883-E902.

A8. Karatay S, Okur SC, et al. Effects of Acupuncture Treatment on Fibromyalgia Symptoms, Serotonin, and Substance P Levels: A Randomized Sham and Placebo-Controlled Clinical Trial. Pain Med. 2018 Mar 1;19(3):615-628.

B. Balneotherapy

B1. Falagas ME, Zarkadoulia E, et al. The therapeutic effect of balneotherapy: evaluation of the evidence from randomised controlled trials. Int J Clin Pract. 2009 Jul;63(7):1068-1084.

B2. Langhorst J, Musial F, et al. Efficacy of hydrotherapy in fibromyalgia syndrome—a meta-analysis of randomized controlled clinical trials. Rheumatology (Oxford). 2009 Sep;48(9):1155-1159.

B3. Baranowsky J, Klose P, et al. Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. Rheumatol Int. 2009 Nov;30(1):1-21.

B4. Terhorst L, Schneider MJ, et al. Complementary and alternative medicine in the treatment of pain in fibromyalgia: a systematic review of randomized controlled trials. J Manipulative Physiol Ther. 2011 Sep; 34(7):483-496.

B5. Fraioli A, Grassi M, et al. Clinical researches on the efficacy of spa therapy in fibromyalgia. A systematic review. Annals Ist Super Sanita. 2013; 49(2):219-229.

B6. Naumann J, Sadaghiani C. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther. 2014 Jul 7;16(4):R141.

B7. Koçyiğit BF, Gür A, et al. Comparison of education and balneotherapy efficacy in patients with fibromyalgia syndrome: A randomized, controlled clinical study. Agri. 2016 Apr;28(2):72-78.

B8. Fioravanti A, Manica P, et al. Is balneotherapy effective for fibromyalgia? Results from a 6-month double-blind randomized clinical trial. Clin Rheumatol. 2018 Aug;37(8):2203-2212.

C. Brain stimulation

C1. Sutbeyaz ST, Sezer N, et al. Low-frequency pulsed electromagnetic field therapy in fibromyalgia: a randomized, double-blind, sham-controlled clinical study. Clin J Pain. 2009 Oct;25(8):722-728.

C2. Hou WH, Wang TY, et al. The effects of add-on non-invasive brain stimulation in fibromyalgia: a meta-analysis and meta-regression of randomized controlled trials. Rheumatology (Oxford). 2016 Aug;55(8):1507-1517.

C3. Shekelle PG, Cook IA, et al. Benefits and harms of cranial electrical stimulation for chronic painful conditions, depression, anxiety, and insomnia: a systematic review. Ann Intern med. 2018 Mar 20;168(6):414-421.

C4. O’Connell NE, Marston L, et al. Non-invasive brain stimulation techniques for chronic pain. Cochrane Database Syst Rev. 2018 Apr 13;4:CD008208.

D. Magnet therapy

D1. Baranowsky J, Klose P, et al. Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. Rheumatol Int. 2009 Nov;30(1):1-21.

E. Manual therapy

E1. Castro-Sánchez AM, Matarán-Peñarrocha GA, et al. A randomized controlled trial investigating the effects of craniosacral therapy on pain and heart rate variability in fibromyalgia patients. Clin Rehabil. 2011;25(1):25-35.

E2. Castro-Sánchez AM, Matarán-Peñarrocha GA, et al. Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial. Clin Rehabil. 2011;25(9):800-813.

E3. Laimi K, Mäkilä A, et al. Effectiveness of myofascial release in treatment of chronic musculoskeletal pain: a systematic review. Clin Rehabil. 2018 Apr;32(4):440-450.

F. Massage therapy

F1. Li YH, Wang FY, et al. Massage therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2014 Feb 20;9(2):e89304.

F2. Yuan SL, Matsutani LA, et al. Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis. Man Ther. 2015 Apr;20(2):257-264.

F3. Bervoets DC, Luijsterburg PA, et al. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. J Physiother. 2015 Jul;61(3):106-116.

G. Mind/Body Therapies

G1. Wang C, Schmid CH, et al. A randomized trial of tai chi for fibromyalgia. N Engl J Med. 2010 Aug 19;363(8):743-754.

G2. Carson JW, Carson KM, et al. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain. 2010 Nov;151(2):530-539.

G3. Bernardy K, Fuber N, et al. Efficacy of hypnosis/guided imagery in fibromyalgia syndrome—a systematic review and meta-analysis of controlled trials. BMC Musculoskeletal Disord. 2011 Jun 15;12:133.

G4. Posadzki P, Ernst E. Guided imagery for musculoskeletal pain: a systematic review. Clin J Pain. 2011 Sep;27(7):648-653.

G5. Langhorst J, Klose P, et al. Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials. Rheumatol Int. 2013 Jan;33(1):193-207.

G6. Jones KD, Sherman CA, et al. A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients. Clin Rheumatol. 2012 Aug;31(8):1205-1214.

G7. Picard P, Jusseaume C, et al. Hypnosis for management of fibromyalgia. Int J Clin Exp Hypn. 2013;61(1):111-123.

G8. Langhorst J, Klose P, et al. Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic reivew and meta-analysis of randomized controlled trials. Rheumatol Int. 2013 Jan;33(1):193-207.

G9. Cramer H, Lauche R, et al. Yoga for rheumatic diseases: a systematic review. Rheumatology (Oxford). 2013 Nov;52(11):2025-2030.

G10. Meeus M, Nijs J, et al. The effect of relaxation therapy on autonomic functioning, symptoms and daily functioning, in patients with chronic fatigue syndrome or fibromyalgia: a systematic review. Clin Rehabil. 2015 Mar;29(3):221-233.

G11. Theadom A, Cropley M, et al. Mind and body therapy for fibromyalgia. Cochrane Database Syst Rev. 2015 Apr 9;(4):CD001980.

G13. Onieva-Zafra MD, García LH, Del Valle MG. Effectiveness of guided imagery relaxation on levels of pain and depression in patients diagnosed with fibromyalgia. Holist Nurs Pract. 2015 Jan-Feb;29(1):13-21.

G14. Baumueller E, Winkelmann A, et al. Electromyogram Biofeedback in Patients with Fibromyalgia: A Randomized Controlled Trial. Complement Med Res. 2017;24(1):33-39.

G15. Zech N, Hansen E, et al. Efficacy, acceptability and safety of guided imagery/hypnosis in fibromyalgia—a systematic review and meta-analysis of randomized controlled trials. Eur J Pain. 2017 Feb;21(2):217-227.

G16. Wang C, Schmid CH, et al. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. BMJ. 2018 Mar 21;360:k851.

H. Other:

H1. Perry R, Leach V, et al. An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools. Syst Rev. 2017 May 15;6(1):97. doi: 10.1186/s13643-017-0487-6. Review. PubMed PMID: 28506257; PubMed Central PMCID: PMC5433031.

H2. Johnson MI, Claydon LS, et al. Transcutaneous electrical nerve stimulation (TENS) for fibromyalgia in adults. Cochrane Database Syst Rev. 2017 Oct 9;10:CD012172.

H3. Matsumoto S, Shimodozono M, et al. Effects of thermal therapy combining sauna therapy and underwater exercise in patients with fibromyalgia. Complement Ther Clin Pract. 2011 Aug;17(3):162-166.

I. Supplements

I1. Ware MA, Fitzcharles MA, et al. The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesth Analg. 2010 Feb 1;110(2):604-610.

I2. Cao H, Liu J, et al. Traditional Chinese Medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials. J Altern Complement Med. 2010 Apr;16(4):397-409.

I3. Hussain SA, Al-Khalifa II, et al. Adjuvant use of melatonin for treatment of fibromyalgia. J Pineal Res. 2011 Apr;50(3):267-271.

I4. deZanette SA, Vercelino R, et al. Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia: a phase II, randomized, double-dummy, controlled trial. BMC Pharmacol Toxicol. 2014 Jul 23;15:40.

I5. Walitt B, Klose P, et al. Cannabinoids for fibromyalgia. Cochrane Database Syst Rev. 2016 Jul 18;7:CD011694.

I6. Stockings E, Campbell G, et al. Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain. 2018 Oct;159(10):1932-1954.

Last reviewed February 2020 by EBSCO NAT Review Board Eric Hurwitz, DC  Last Updated: 5/25/2020